Monday, August 2, 2010

Eating Disorders & HAES

Right now I'm on an eating disorders rotation, mostly seeing girls who are very, very sick with Anorexia Nervosa. There are a number of things that make me think about HAES. Sometimes it's hearing about how these girls were affected by the health programs at their schools, that typically talk about "healthy eating". This Red Light, Green Light program seems pretty typical of what is taught -- some foods are bad, and should be eaten as little as possible. These kind of programs piss me off to no end. But one thing that I heard someone say this week was along the lines of "The problem with these programs is that the kids who don't need them end up taking them to heart and cutting out foods to the point of becoming unhealthy, and the program doesn't have an impact on the kids who do need to listen." Now this pisses me off even more. Yes, the programs are bad for the kids who, for whatever reason, build the false messages into the development of serious eating disorders. But they are also bad for the fat kids who get the message that they are bad, their bodies are bad, their eating is bad, and their fat is their fault. And I know that this is what I should expect at this point in my medical training ... but somehow I expected more of the folks who work in eating disorders.

The other part that really gets to me is that there's all this lip service to 'people come in all shapes and sizes', etc. But I get the distinct feeling that there's the hidden caveat of "except if you're REALLY fat" attached to it all. There are posters depicting women at a range of sizes, from thin to slightly chubby, but never with someone who is outright fat. It's hard for me to tell how much of this is me overreacting vs. what's really going on, but so far, there have been some tough moments for me working in this environment.