Medical School and Eating Disorders

“I see even medical school couldn’t immunize you against anorexia.” I was told this while in inpatient by the weekend (ie non-eating disorder specialist) psychiatrist. During this stay, some of the other patients on the inpatient unit included two nurses, a nurse practitioner, a doctor, and several other students interested in the medical field.

Just based on my personal experiences in treatment, I would argue that people interested or involved in health professions are overrepresented in the eating disordered population. In a way, this makes sense. An eating disorder usually involves an obsession with numbers, order and logic, so it is not hard to see why those with an eating disorder would also be attracted to fields that involve science, numbers, and a quest for order and logic. Moreover, studies have shown that those with eating disorders are often high achieving, highly motivated people with perfectionistic tendencies – the same personality traits that are usually necessary to succeed in the medical field.

It is a common misconception that people with eating disorders do not understand how much damage they are doing to their bodies. While it is easy in today’s weight obsessed culture to think “going to the gym more is better for me” or “cutting calories will make me healthier” (since every other commercial on TV pretty much says these things), most people with eating disorders do reach a point, whether medically trained or not, where they know what they are doing is harmful. It is not about being smart or being stupid.  As Leo says on West Wing, “do you know how many alcoholics are in MENSA?”  I don’t need a science class to tell me that eating 500 calories a day or throwing up after eating is not normal or healthy.

So if I know it’s wrong and hurting my body, why do I keep doing it? I think part of it goes back to the addictive nature of eating disorders.  In response to an email my mom once wrote that said “Enough is enough with your anorexia” and also “I want you to know that this eating disorder is very dangerous to your health” (um, no shit sherlock) I wrote:

“to help you understand why this is so hard, imagine if I told you that you had to go a whole day without eating.  That would be very hard and unnatural for you, and by the end of the day you would probably feel pretty sick.  Well the same way you would feel if you couldn’t eat all day is the way I feel when I do eat! I have been doing it for so long, that eating feels wrong and unnatural to me in the same way that not eating feels wrong to you.  It’s like alcoholism in a way – most alcoholics know they are drinking too much, but that doesn’t mean it is easy to stop.”

And then there is denial. I will admit, biology courses and medical school made me much more aware of the specific problems my eating disorder can cause and why it can cause those things, making me a little less cavalier about feeling faint or a bad EKG.  I have also had two friends from treatment pass away recently.  But even then, I have managed to convince myself that I am fine, that those other people were really sick, but because there are others out there who weigh less than me or eat less than me I am really not all that sick.

Beyond that, I also think I lack the basic self-respect for my body as a biological organism. One of my friends in medical school told me how she wants to lose some weight, but could never crash diet because she knows her body needs fuel. I have the same knowledge, but somehow, I manage to disconnect my knowledge of the human body from MY body. As Marya Hornbacher so eloquently writes in Wasted: A Memoir of Anorexia and Bulimia, “you stop seeing your body as your own, as something valuable…I have a body [rather than] I am a body.” Rather then viewing my body as a biological organism, I view it as this “thing” attached to my mind that I want to reshape and remake.

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4 thoughts on “Medical School and Eating Disorders

  1. I enjoyed this post. Although I am not in med school, I’m a grad student who’s studied nutrition extensively and a former dancer who understands how the body works. I despise the patronizing lectures detailing how unhealthy!! and unsafe!! and bad!! eating disorders are, too.

    It’s a psychological disorder. Yes, I know I’m destroying myself, but I’m not at liberty to stop. Why would anyone do this on purpose, even if there were no health consequences?

    Anyway, thanks for an honest and insightful post. Best of luck fighting through this!

    • Thank you so much for the comment – keep them coming please! I am also a former gymnast so I can relate to the frustration you must have felt while dancing and hearing those comments. This is where I find the drug and alcohol analogy very helpful. Most people do not say to an alcoholic “just stop drinking.” They recognize that it is a disorder and hard to get under control, rather than just try to scare them into stopping. While I think it is important to be aware of the health consequences, and I will admit that my new knowledge has led me to seek treatment sooner as I know what can happen if I keep starving, it is by no means as simple as that. Best of luck to you too!

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