Leeds experts on fostering a healthier campus culture for Eating Disorder Awareness Week

As Eating Disorder Awareness Week draws to a close, The Leeds Tab spoke to university professors about how students can promote a better culture on campus around food and body image.

With the theme this year being “anyone can be affected by an eating disorder”, The Leeds Tab began by asking Andrew Hill, a professor of medical psychology at the University of Leeds, and Netalie Shloim, a private practitioner and the professional lead for the MA in counselling and psychotherapy, what some of the most common misconceptions are about people with eating disorders.

‘Don’t stereotype your view of who the typical person with an eating disorder is’

Both professors emphasised how eating disorders can impact anyone of any gender, age, ethnicity, race or body type, with Andrew saying that we should not “stereotype [our] view of who the typical person with an eating disorder is”.

Netalie explained the importance of understanding that eating disorders are complex mental health conditions, so they should not be viewed as a choice or a phase.

Less than six per cent of people with eating disorders are medically diagnosed as “underweight”.  In fact, people in larger bodies are at the highest risk of having developed an eating disorder in their lives.

Netalie said: “We might look like we’re at a normal and healthy weight but really struggle with our eating disorder, body image and body perception.

“Or, we might be at a very low or high weight and feel absolutely fine and really content with our body.”

These misconceptions can influence the treatment people receive. For example, a person may be told by their GP that their BMI isn’t low enough to qualify for anorexia.

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“Is the GP sending them back home to lose some weight, and then they can come back and get treatment?” Netalie added.

Research also shows there are few, if any, differences in eating disorder prevalence and presentation across ethnic groups. Despite this, individuals from ethnic minority backgrounds in the UK are less likely to seek and receive eating disorder treatment.

‘It’s a big step up to start talking to people about these issues, but it’s important’

When asked why we should be having open conversations about eating disorders at university, both professors emphasised the importance of reducing stigma, with Andrew noting that whilst “it’s a big step up to start talking to people about these issues”, it remains an “important” one.

Netalie noted how students arrive in Leeds from a variety of backgrounds across the globe.

This means it’s important to be aware of how eating disorders may look across different cultures, whilst also understanding that they’re about “so much more than eating or not eating”.

By encouraging open conversations, Netalie explains, we can identify and offer interventions as soon as possible.

Approximately 1.25 million people in the UK are living with an eating disorder, which equates to about one in 50 people.

Eating disorders are responsible for more loss of life than any other mental health condition. Unfortunately, eating disorders are becoming increasingly common, with UK hospital admissions having risen by 84 per cent in the last five years.

Students fundraising for BEAT in Leeds University Union

‘Reinventing yourself as an independent adult is a major challenge for students’

Student life can create unique pressures that may contribute to eating disorders or disordered eating.

Andrew highlighted how transitional phases are important when looking at eating disorder development, and going to university is often a big transition in a person’s life.

He said: “Reinventing yourself as an independent adult is a major challenge for students, and then divorcing yourself from the day-to-day support mechanisms that you had at home.”

Andrew also cited the practical difficulties for people with a history of eating disorders coming to university.

Managing the transfer of care from a home GP, or specialist treatment to a Leeds service, can present several challenges, especially when many students only live in Leeds during term time.

Speaking about academic pressures, Andrew explained that they are “just different” to previous studies: “It’s much more self-determined study and certainly for our medical students, we’ve taken some very high achievers from individual schools and put them all together in a melting pot of competition”.

Netalie pointed out how the financial constraints of a student budget can impact food choices: “It’s more expensive to buy a balanced food shop […] it’s cheaper to just buy pizza or bread and snacks.”

She also explained that moving into halls or student housing often brings an increased exposure to diet culture, because you’re mixing with people from different backgrounds: “You may live with someone who experiences challenges with food or body image, and that may lead to more conversations and more comparisons.”

Netalie Shloim

‘The problem is when these comparisons are narrowed down to a very tight focus and a very moral message: This is good and this is bad’

Looking at how social media and gym culture on campus can contribute to body image issues, Andrew began by explaining how comparing ourselves to others is a basic human need, and helps in the construction of our identity.

“The problem is when this comparison is narrowed down to a very tight focus and a very moral message: This is good and this is bad,” he said.

Speaking about trends like “what I eat in a day” and “clean eating”, he added: “It’s that classic bit of social marketing and advertising, isn’t it?

“You see exemplars of behaviour. You see successful, reasonably rich people doing these things […] and the temptation is to follow them as models.”

Netalie highlighted the value of exercise for wellbeing and emotional regulation, as well as the many positive impacts it can have on helping individuals better manage their eating.

But she spoke about how a relationship with exercise can deteriorate into a preoccupation with, or addiction to, sports or calorie counting.

She said: “It’s important to have these conversations, to be open about how overexercising is also unhealthy.”

Bodywhys, an eating disorder association in Ireland, has reported that a rise in eating disorders amongst men was linked to a growing gym and fitness culture.

via YouTube

‘There is so much more to life than being a bit smaller or a bit larger’

Looking ahead, The Leeds Tab asked both professors how we can promote recovery and foster a more positive relationship on campus around food and body image.

Andrew noted how eating disorders serve a function for those struggling, often helping to manage their mood or life when other aspects feel out of control. This can create resistance to treatment not seen in many other psychological health problems.

Helping a friend, especially one resisting recovery, is about not becoming “complicit”: “Don’t become a friend of the eating disorder, but maintain your friend. Help support them. But don’t help support the eating disorder.”

He stressed that we should not see the person as the eating disorder: “They are someone with a complicated, internal emotional life, but they need your friendship. They need your support”.

Andrew explained that intervening can feel uncomfortable: “Now, who am I to step in and say: ‘I’m not sure about what you’re doing here. You know, all these protein supplements you’re taking in preparation for your weight training, for example. Is that a good idea?’

“We don’t feel all that qualified.”

But we should be prepared to step in more actively, “asking people if they’re okay when they’re making strange food choices, or they’re back in the gym for the third time that day.”

Whilst it can be daunting to start these conversations, it’s important. “People have responsibility. Be vigilant,” Andrew added.

Netalie spoke about encouraging students to communicate their needs and helping tutors to recognise the signs, because “sometimes we are afraid to ask.”

Promoting recovery means establishing routines and prioritising self-care, with Netalie explaining that too often “we are last in our own list”.

She added that realistic goals are essential, moving from being consumed by thoughts around body image and eating to those thoughts becoming more of a background hum: “I am managing the eating rather than the eating is managing me”.

Netalie explained how we all exist on a spectrum. Whilst some may adopt conscious or unconscious disordered eating habits, if these are not taking over their life, it’s not a huge cause for concern.

But the other end of this spectrum is where people begin to be controlled by food and eating, with Netalie stressing: “It’s important to know that it’s a slippery slope, and can rapidly deteriorate from wanting to just lose a kilo or two.”

She highlighted the inherent loneliness of managing an eating disorder: “You gradually shift from having a relationship with society and friends to having a relationship with the eating disorder.

“And it’s just not worth it. There is so much more to life than being a bit smaller or a bit larger.

“It’s about being healthy, it’s about enjoying life. It’s about interacting with others. It’s about living and, at the end of the day, if we are a bit smaller or a bit bigger, is it really important?”

If you have been affected by any of the topics raised in this article, help and support are available at the following services.

BEAT is the UK’s leading eating disorder charity. There is a helpline and chatroom on its website, alongside many resources for those living with an eating disorder, or those looking to help someone who is struggling with one.

CONNECT is West Yorkshire’s adult eating disorder service. It operates in four tiers, with each tier created to support individuals with eating disorders in different ways. The open access pathway is available to anyone experiencing an eating disorder/disordered eating, whether you have a diagnosis or not.

Leeds University Union outline university services on this page, alongside online support groups for students.