National Eating Disorders Association

The Communication Illusion

Carrie Eaton

 If you could unlock a recovered eating disordered brain to peer inside most people would be amazed at the distinct memories of the journey.  As a seasoned nurse, perhaps my memories are more technical than a non-healthcare professional, but whether you are a nurse, college student, or stay at home mom, there are healthcare providers you recall with compassion and those you remember for their unfortunate ignorance.  Why do so many healthcare providers disregard the possibility of underlying eating disorder issues and simply treat presenting symptoms? I stumbled upon a recent article titled, "Identifying Eating Disorders in Teens and Getting Treatment are often Difficult Tasks" (Nauert, 2012). While the title holds true, I would expand that statement to teens and adults. 

I will admit there is tremendous investigative work involved in diagnosing an eating disorder when a patient presents with alternative complaints. Eating disordered patients are notoriously ambivalent to admit the true nature of their presenting symptoms.  However, it takes basic screening tools accompanied by a time and energy investment to uncover a teen or an adult enmeshed in the web of disordered eating. Early intervention holds the key to unlocking a potential lifetime struggle. As a RN I view an intervention as a valid investment in a patient's future. 

With this in mind, I am continually amazed at the narrow intellectual lens that many healthcare providers view patient's symptoms despite a clear red flag towards an undiagnosed eating disorder. In the hospital setting, we screen for potential latex allergies, drug and alcohol use, sexually transmitted infections, depression, suicide risk, and a myriad of other possibilities. How often do nurses and doctors screen for high risk eating disorder behaviors? Simply asking, "Do you have a history of an eating disorder?" is not enough.  In the words of George Bernard Shaw, “The single biggest problem with communication is the illusion that it has taken place.” It is important to recognize that people with eating disorders are often reluctant to seek help. Therefore, screening should consist of open ended questions and empathetic understanding in an effort to elicit detailed information on an admission history. 

In 2003 and again in 2005, I was fortunate enough to come across well-educated healthcare providers who recognized the red flags associated with my eating disorder. Despite being reluctant and angry at the prospect of intervention, they persisted in their endeavors and ultimately saved my life. I am one of the lucky ones. The ER doctor who spent well over an hour at my bedside helping me comprehend treatment trade-offs in the face of an eating disorder is now my primary care physician. He took the time to decipher the illusion of control I created and broke down barriers using communication. I am forever grateful for his persistence. I am here today because ER nurses and doctors recognized the chance to provide, “…a wakeup call, a teachable moment, a chance to tell…" me I needed help (Nauert, 2012).

Do you have an experience to share about healthcare communication illusions in your eating disorder journey?

References: Nauert PhD, R. (2012). Spotting Eating Disorders in the ER. Psych Central. Retrieved on February 7, 2013 from: Shaw, George Bernard quotes. Retrieved from on February 7, 2013. 

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