Interview by Talia Cecchele with Elaine
It's not uncommon for people with eating disorders or experiencing disordered eating to have a strong interest in nutrition or to work in a health-related career. I've supported dietitians, nutritionists, doctors, nurses and other health professionals to recover from their eating disorder and overcome disordered eating.
I'm frequently asked if working in the field of nutrition is appropriate when recovering or after having recovered from an eating disorder. There are definitely pros and cons so I thought it might be helpful to get some personal insight from someone who has been there before. Elaine was a registered dietitian for 10 years working in the NHS, private sector, doing clinical work and in academia, as a supervisor and as a trainer before giving up her registration. She currently works in management in higher education. Let's find out Elaine's story...
Can you tell us what your relationship with food was like growing up?
Up until about fifteen I ate what my parents gave me. I was a 'good girl' not being fussy like my brothers with fruit and veg and eating 'large' portions almost as big as my weight lifting brothers.
When did you develop an unhealthy relationship with food and/or your body?
I received a comment from a girl in my class after a party one day which sticks as a trigger "Elaine's belly was bigger than her boobs in that dress". Later that year, I had two weeks off school with a suspected inner ear infection, felt dizzy and subsequently didn't eat much as I was nauseous. On the return to school after my time off I got some compliments for my 'weight loss'.
I'm not sure when after this I decided to eat 'healthily'. Like anything I put my mind too, I was determined and committed and subsequently became very 'good' at dieting. By seventeen, I had lost a fair bit of weight and I was receiving lots of compliments from family and friends for how great I looked.
Why did you decide to study Dietetics?
I had always wanted to be a school teacher but after seeing my mum work all hours, I decided that I wanted a 9-5 job. I was predicted straight As at A level and part of the 'Gifted and Talented' group of kids at school (hello high achiever, perfectionist!). I was taken to Oxford University and encouraged to apply as part of the widening participation strategy, which attracted children from comprehensive schools. I remember thinking if I apply here, I will get really ill because I knew my dieting was getting out of hand.
I scrolled through UCAS, trying to find something I could study and came across Dietetics... 'ping' my food obsessed brain liked this idea. I wrote my application with the reasons I wanted to study; I loved cooking, interested in sports nutrition and I had seen how weight loss had helped medical conditions notably diabetes from my part-time job in a local pharmacy. These reasons were true but the overarching appeal was that I would learn everything about healthy eating and never be 'fat' again (looking back I recognise I probably met the criteria for orthorexia at this time). I wasn't alarmingly slim at the time of my Dietetics interviews and I passed the GP health record check that was carried out to exclude an eating disorder which was part of the nutrition and dietetics course admission.
Just after my 18th birthday with a few months looming to my A levels exam I dieted more and more, my day was revision and restriction. I remember after my Geography exam telling my friend my period was late and it must be because I was so stressed. This was the start of amenorrhea which I had on and off for the next 8 years of my life.
What was your experience studying dietetics with an eating disorder?
Once my A levels were over and I realised that I was going to uni to study dietetics I remember a panic setting in that I would be found out for having (self-diagnosed) anorexia and so I made a conscious effort to eat more. By May of my first year of uni, I had a period again. This didn't last long and by the time I was 21, I had turned back to my old friend anorexia and looked emaciated, so much so my personal tutor called me in as she and some of the lecturers were concerned, I had lost weight. I laughed it off and said yes I need to apply the 'food fortification' advice to myself and the weight loss had been because I had such poor cooking facilities and was miserable on placement. Again, the fear set in and I made an effort to gain weight.
By the time I graduated and started my first job, my periods were back. They went again during my next stressful job. At 25, after completing the BDA Paediatric module which briefly covered eating disorders and how to work out how to help someone gain weight with anorexia, I plotted my own graph and I decided I couldn't not have periods. By 2012, aged 26 I got my period back and I have never lost it since.
What made you decide to leave the dietetic profession?
I made a great success in Dietetics, working in the NHS, privately, in education winning awards and presenting internationally. But by my late 20s I was bored. As my weight had restored and I had maintained a healthy BMI my brain was no longer starved and food obsessed. I completed a Masters in education and decided not to renew my Dietetics registration.
The saddest thing was that I experienced so much shame for being a dietitian who had an eating disorder, I couldn’t tell, albeit a few close friends, the real reason I was leaving was actually to be my authentic self and heal my mental health once and for all.
Do you have any advice for someone considering or working in the nutrition field with lived experience?
I remember a counsellor telling me that all therapists were wounded soldiers once. For me leaving the dietetics profession was the only way I could see to lose my 'anorexia/diet obsessed identity'. For others, knowing what their patients are going through I feel they might be able to provide a unique understanding, cognitive and emotional empathy from lived experiences rather than text book learning.
As I have embarked on discovering food freedom and trying to become a more intuitive eater, I have come across a number of dietitians who admit they suffer or suffered from disordered eating and eating disorders. Interestingly, results from the Starvation Experiment (1944-1945) by Dr. Ancel Keys showed that when people are starved they become obsessed with food. Two of the men who had been part of this study went on to be chefs and another work in the food industry (and there were only about 30 participants). You can read more about the starvation study here.
Nutrition and Dietetics courses will continue to attract individuals in the midst of disordered eating. I feel more training is required to help recognise nutrition students and colleagues that may be suffering and provide encouragement and support to enable them to get the help they need for their eating issues.
I hope sharing this helps others working in the field reach out, or to have the courageous difficult conversation with a colleague you are concerned about their weight or eating.
Thank you Elaine for sharing your experience.
Should I pursue a career in nutrition?
At the end of the day, you are the only person who can honestly say if your decision to study nutrition is being driven by your eating disorder, or a pre-existing interest in nutrition/health. I know dietitians who had disordered eating or an eating disorder that studied nutrition and this helped them to recover and I know dietitians that entered a nutrition career and realised it wasn't for them. There are some incredible nutritionists and dietitians with lived experience now helping others to overcome disordered eating. If you want to work in eating disorders and are a nutritionist or dietitian, I wouldn't recommend this until you are fully recovered so that you can give the best possible support to your clients/patients and to know that your passion is coming from a healthy place.
It is so important to reach out for help if you are struggling. There is no shame if you are a working in the nutrition field, at the end of the day we all have a relationship with food and deserve for it to be a healthy one.
Talia Cecchele
Talia Cecchele Nutrition is a team of registered dietitians specialising in eating disorders and disordered eating. We aim to bring balance back to nutrition, help you to break free from food rules and find food freedom. To enquire about private consultation please fill out a contact form.