February 1st-7th, 2016 marks Eating Disorders Awareness Week (EDAW), an initiative aimed at promoting the message that “eating disorders can and do affect everyone” (National Eating Disorder Information Centre, 2014). Although there is no single cause for eating disorders, concerns about body weight and body shape play a role in all eating disorders. The actual cause of these disorders appears to result from a combination of genetic, neurobiologic, socio-cultural, behavioural, and psychological factors (Williams, Goodie, & Motsinger, 2008). Since eating disorders involve private rather than public behaviour, assessment in the work environment can be quite difficult (Tompkins, 2011).
TYPES OF EATING DISORDERS
The Canadian Mental Health Association identifies three main types of eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder. It is important to note that signs of an eating disorder can often start before a person looks unwell, so weight should never be the only consideration (Canadian Mental Health Association, 2014). Below is a quick overview of each eating disorder type.
Individuals who experience anorexia nervosa may refuse to keep a normal weight for their body by restricting the amount of food they eat or by excessively exercising (Canadian Mental Health Association, 2014). They may feel overweight regardless of their actual weight, and may equate their body weight with self-worth. Anorexia nervosa can affect a person’s entire body with implications such as:
- Heart and kidney dysfunction
- Low blood iron
- Bone loss
- Digestive problems
- Low heart rate and blood pressure, and;
- Fertility problems in women
As many as 10% of individuals who experience anorexia nervosa die as a result of health problems or suicide (Canadian Mental Health Association, 2014).
Bulimia nervosa is characterized by periods of uncontrollable binge-eating, followed by purging (eliminating food via vomiting or laxatives) (Canadian Mental Health Association, 2014). Individuals who experience bulimia nervosa can feel overweight regardless of their actual weight. Health problems caused by bulimia nervosa may include:
- Kidney problems
- Dehydration and;
- Digestive problems
Due to the purging nature of bulimia nervosa, vomiting can also damage an individual’s teeth, mouth, and throat.
Binge-eating disorder involves periods of over-eating. Individuals who experience binge-eating disorder often feel like they can’t control how much they eat, and feel distressed depressed, or guilty after the act of bingeing (Canadian Mental Health Association, 2014). Binge-eating is often done in secret, and can be a way to cope or find comfort. Some individuals may fast (not eat for a period of time) after periods of binge-eating due to feelings of guilt. Binge-eating disorder can increase the risk of medical complications such as Type 2 diabetes, high blood pressure, or weight concerns.
IMPACT IN THE WORKPLACE
Eating disorders can have a major impact on an individual’s ability to function in the workplace and pose a challenge for employers who have an employee with an eating disorder (Weltzin, 2001). Impacts include work performance issues such as diminished quality or quantity of work, concentration lapses, decrease in problem solving skills, missed deadlines, presenteeism, or absenteeism (Tompkins, 2011). Other more specific signs in the workplace may include withdrawal from normal social activities, a distorted body image (e.g. complaining to others about being fat despite being underweight), and preoccupation with food and unusual food behaviours (e.g. not wanting to eat in front of co-workers) (Tompkins, 2011).
While eating disorders present some unique issues in a work environment, several options are available when an employee is suspected of having an eating disorder or needs treatment. It is important to note that denial and concealment of these problems occur almost universally in the early course of treatment. Conversely, it is not uncommon for employees to seek help from someone in the workplace as a first step in their recovery process. Directing the employee to a medical provider such as their family physician should be the first step in this process.
Modifications in the work environment and schedule can help facilitate recovery from an eating disorder (Davies, 2015). 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, dietitians, and physicians involved in their care.
Flexible scheduling - Being open to scheduling changes can go a long way toward helping an employee received 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 (as opposed to rotating shifts) and reduced or limited work hours can be helpful until the employee has shown better eating habits.
Since psychiatric medications are often used to treat eating disorders, side effects need to be taken into account to ensure that the medications do not impair safety in the workplace. Employers should also be aware of employee tardiness, increasing use of sick days, and decreased productivity, which can be signs of relapse (Davies, 2015).
How are you raising the awareness of eating disorders in your workplace? Let us know in the comments below!
Canadian Mental Health Association. (2014). Eating disorders. Understanding Mental Illness. Retrieved from https://www.cmha.ca/mental-health/understanding-mental-illness/eating-disorders/
Davies, N. (2015). How to manage eating disorders at work. Occupational Health & Wellbeing: Workplace Wellbeing News and Guidance from Personnel Today. Retrieved from http://www.personneltoday.com/hr/manage-eating-disorders-work/
National Eating Disorder Information Centre. (n.d.). NEDIC Blog. Retrieved from http://nedic.ca/
Tompkins, O. (2011). Eating disorders at work. Nursing, 59(10): 480. Doi: 10.1177/216507991105901009
Weltzin, T. E., Cornella-Carlson, T., Fitzpatrick, M. E., Kennington, B., Bean, P., & Jefferies, C. (2012). Treatment issues and outcomes for males with eating disorders. Eating Disorders, 20(5): 444-459. Doi: 10.1080/10640266.2012.715527.
Williams, P. M., Goodie, J., & Motsinger, C. D. (2008). Treating eating disorders in primary care. American Family Physician, 77(2): 187-195.
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