When Your Doctor Isn't Concerned About Your Eating

Oftentimes, people come into The Kahm Clinic concerned that they have an eating disorder but also thinking that they’re okay or not “sick enough” to need treatment. Why do they believe that? Because their doctor says so! Usually, they’ve gone to the primary care physician with their worry and been told that they’re at a normal weight for their height. In some cases, their physician may even complete a blood work panel with normal results.

To no fault of primary care physicians, there is a lack of awareness when it comes to screening for eating disorders, especially during a normal visit. “Think about the last time you went to the doctor’s and they asked about your eating habits — not in a way to encourage you to lose weight but to truly determine your thoughts around food or if you’re restricting your intake,” explains dietitian Elaina Efird, RDN, CD, CEDRD, CSSD. 

Everyone should be screened for an eating disorder, just as they are for other potential health concerns. 

Consider this statistic: 30 to 50 percent of eating disorders remain undiagnosed because of denial or shame about seeking treatment or because they are missed by healthcare professionals. As an example, Elaina shares that patients often tell her that they lost a lot of weight — say 30 pounds — in a short amount of time through strict restriction and over-exercising. When they go to see their doctor, they get praised for it rather than being asked about how they achieved their results.

As another source of evidence concerning this growing problem, in a study of 637 residency programs, 514 of them (80 percent) had no training in eating disorders. These results show how little is known about eating disorders, especially for healthcare professionals who don’t work with patients during treatment. Many individuals mistake “healthy eating” with an eating disorder or an eating disorder with “healthy eating” — which is why “it’s so important to educate on what to look for, how your body can change because of an eating disorder, and why you deserve treatment,” Elaina adds. 

Let’s revisit the idea of normal blood work in the presence of an eating disorder. 

“Our bodies are really good at adapting, for better or for worse,” Elaina says. In previous blog posts, we’ve discussed how your metabolism adapts to restricting caloric intake or how what your body burns as fuel changes based on what’s available from your diet. Your body is good at that when it comes to blood work too!

Your body is designed to keep you alive. The goal is to maintain homeostasis, or a state of being stable — and that can show through blood work. Elaina saw this truth when she worked in an inpatient eating disorder treatment center, the highest level of care. “It’s for individuals who are medically unstable and very low in body weight. They often have a lot of issues because of their eating disorder and are at risk for death,” she explains. “Even so, in most cases, we would see that their blood work was okay.”

So no matter what you’ve been told by a healthcare professional or your blood work results, if you’re battling negative food behaviors or constant thoughts about your body and/or food, seek help!

Advocate for yourself. Get a second opinion. You know that those behaviors and thoughts are not healthy and not representative of your best self. “You do deserve treatment,” Elaina concludes. “I don’t want you to feel shame for needing that help.”

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