Body image: a GP’s advice on eating disorders in the workplace

Employers have an important role in, and responsibility for, supporting staff members who may be struggling, says Dr Shazia Bhatti. She describes what all managers and employees should know about eating disorders in the workplace

This is an edited version of an article that first appeared on the People Management website.

An eating disorder is a mental health condition that can have damaging physical and emotional consequences. People with eating disorders tend to compare their appearance and accomplishments against unrealistic standards and, typically, find themselves lacking.

Approximately 1.25 million people in the UK struggle with an eating disorder and, like other illnesses, they can affect people in the workplace. If left untreated an eating disorder can impact the sufferer physically, psychologically and socially, and may even be life-threatening. Therefore, employers have an important role and responsibility, as well as a moral obligation, to support any staff members who may be struggling.

It’s important to remember that eating disorders are not actually about food, but feelings. The way the person interacts with food is a coping strategy – it may simply make them feel able to cope with another issue or to feel in control. Triggers like stress, or feeling out of control, can bring about an eating disorder, as can genetic, social and neurological factors.

In the working population, eating disorders are most likely to be found in the 16- to 30-year-old age range, although it is possible to have an eating disorder for many years, even for life, so older employees may also be affected.

The difficulty for employers is that eating disorders are not easy to recognise – because they are a coping mechanism for the person, they try to keep it secret. Eating disorders can have an impact on person’s ability to function in the workplace which can be seen as a weakening in the quality or quantity of work. However, if you suspect an employee may be struggling, there are a few tell-tale signs you may see.

  • Obsessing over thinness and thin people; making comments about people’s weight.
  • Occupied with food, dieting and counting calories.
  • Avoiding eating in front of others.
  • Exercising excessively.
  • Mood swings.
  • Poor decision-making abilities.
  • Difficulties concentrating.
  • Increasing stress and anxiety.
  • Social withdrawal.
  • Irritability.
  • Missing deadlines.
  • Avoiding events where food might be present.
  • Evidence of purging.
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What could trigger the condition at work?

Stress is a major culprit. The relationship between stress and eating disorders is a vicious circle. Feelings of being stressed or overwhelmed can trigger disordered eating behaviours, which are used as a coping mechanism; in a similar way, the compulsive behaviour, fears and constant negative thoughts that characterise eating disorders raise stress levels.

The relationship between stress and eating disorders is a vicious circle.

Other triggers in the workplace – such as not enough time for lunch breaks, canteens at work providing specific foods as opposed to options and vending machines with chocolates, sweets or snacks – can exacerbate the guilt/stress cycle.

What does treatment involve, and how can you help?

When an employer suspects an employee of having an eating disorder, and being in need of treatment, directing the employee to a health professional is usually the first step in the process. Employers can offer several options to encourage recovery including:

  • Time off – individuals with an eating disorder will need time off for medical appointments to consult with therapists, dieticians and doctors involved in their care.
  • Flexible scheduling – scheduling changes can help in encouraging an employee to seek adequate treatment.
  • Limited/routine work schedules – it is important for an employee with an eating disorder to have a regular schedule in terms of meal times so that normal eating behaviours can develop. A time-limited accommodation of a regular work shift, and reduced or limited work hours, can be helpful until the employee has shown better eating and coping habits.

Dr Shazia Bhatti is a general practitioner at London Doctors Clinic.

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