Careless Words

men-in-waiting-roomThrough talks and the blog, I have the privilege of hearing different stories.  One woman I’m in contact with is struggling with an eating disorder. Wearing layers she looks slim but okay.  Yet she finds it almost impossible to eat. To the point where even children’s clothes are now too big.

She knows she has a problem. And though terrified of gaining weight, she wants to get help.

After months of encouragement, she faced her biggest fear, registered and made an appointment with a GP.  This, she says, was one of the scariest things she’s had to do.

‘It’ll be worth it’, we argued, ‘you need professional support’.

She waited for her appointment, fighting the urge to flee. ‘Maybe I’m okay’ she said.  ‘No’, we answered, ‘you know you’re not’.

So she stuck it out. Took a deep breath and went into the surgery.

‘How can I help you?’

‘I think – I think I maybe have an eating disorder.  I’m scared to eat and I’d like to get help’.

The GP looked her up and down.  ‘You look healthy enough’ .

She swallowed. Twisted her foot and tried again.

‘I’m terrified of gaining weight.  I can’t make myself eat’.

He tapped his pen.  ‘Tell me what you see when you look in the mirror’.

A pause as her mouth twisted. ‘Like X celebrity, before they got a gastric band’.

The GP leant back – and laughed in her face. ‘You know that’s ridiculous’

‘No.  Yes.  I don’t know’.

‘How can you think you’re fat?  There’s nothing of you!’

‘Are you depressed? I can help you with that’

‘No.  No – not especially.’

‘How about anxious?’

‘No. It’s the – food’.

‘Well I’m afraid we can’t help you.  If it was depression or anxiety-related, then yes.  But if it’s just this –  then all I can suggest is you eat more’.

‘So you can’t do anything?’

‘ I can give you a helpline number and they might recommend some counselling’.

‘That’d be good.  But who would pay for it?  We don’t have the money’.

‘Sorry I can’t help you.  But like I say, give them a try.  And keep eating.’



22 thoughts on “Careless Words

  1. In this so-called enlightenend age, I find it scary that a doctor could be so crass and uncaring! Poor lady, wish I could help

  2. No?! Surely not? That’s dreadful.

    Please let her know somehow we all think she’s amazingly brave and are praying for her – especially praying she’ll somehow get better support from somewhere.

  3. Sadly, I can believe this after the experiences I went through with a friend.
    Just awful. Where do people go?
    And really, it could be any one of us.

    Only God…

  4. I don’t want to hurt you Emma, but maybe the GP-s are fed up with these sort of problems. If this country wouldn’t have such a good benefit system and life wouldn’t be so easy, people would have to concentrate on survive as in other countries and wouldn’t have even time to check themselves out in the mirror all day long. When tragedies, real difficulties starts to hit you in your 20’s or 30’s and nothing behind to give you support, then you will take your last breath to go and sort out your life. A few weeks ago I went home and I asked for an appointment to a private clinic for yearly health check. Few years ago I needed to sign up at least 1 month in advance. Now I received appointment for the next morning. Do you know why? Because nobody can afford anymore to go to the doctor. People here take so many things for granted without realising it. But I do think now easy lifestyle brings depression and mental problems. I do think living in a poorer country it can be difficult but it can be a blessing on long term in many ways.

  5. Sadly, this is totally believeable: I’ve heard similar stories and experienced similar too. It makes my blood boil. I wish there could be a secret register of GPs who understand what a mental health problem is and who have some humanity, so that these kinds of appointments which take such phenomenal courage to make, were not such a gamble.

  6. PS I do want to say that I have also experienced GPs who DO get things, and offer practical help as well as genuine empathy and time to listen.

  7. I had the same experience. The first GP I went to told me to just eat more and to replace low-calorie foods with high-calorie ones. A couple of years later (it took that long to pluck up the courage again) I tried a different GP – same response. A few years later (it took me that long to again pluck up the courage) I tried a third GP – who took me seriously, even though my BMI was not quite low enough to be classified as anorexia. She referred me to the local adult eating disorder clinic but didn’t leave it that – she has had me back to see her every 6 weeks ever since. Please tell your friend to try again with a different GP, and if possible to find out beforehand from others who might know some of the local GPs, which one might be most helpful. And well done her for plucking up the courage to go in the first place.

  8. Hi I am a GP with an interest in eating disorders and that is appalling. I would really encourage your friend to try to go back to another GP who might be more sympathetic.

    If there is a website for the practice see if it contains profiles of the doctors at the practice as often they will state their specialist interests or ask the reception staff-that’s what happens at our practice. Of course the GP in question could have done that but…

    The only mitigation I can think of is that mental health and eating disorders in particular are a real Cinderella speciality. In my area the Eating Disorders service has become a tertiary referral service meaning I as a GP cannot refer directly anymore, but have to go through adult general mental health who are not always the most helpful. I have no discretion to refer anyone outside the very strict guidelines anymore either (in the past I could) now I have to wait for someone to drop their BMI enough to qualify- so Debs above would no longer get referred until she was deemed ill enough.
    The Eating Disorders Service similarly has had its funding slashed-we used to have a full time consultant, clinical psychologist, an OT and 2 CPNs. Even with that the service struggled to cope with demand and keep waiting times down. Now there is a very part time consultant, an OT, 1 CPN and a part time psychologist. So it may well be sadly true that the GP could do nothing-in which case blame the govt for their lack of funding.
    We have an excellent eating disorders charity in South Yorks, hopefully there might be one close to your friend and this may be the only possible route to help given the current funding situation. Please encourage her to try again. And I am so sorry she met with that response.

  9. oh makes me so angry after she was soo soo brave. hope she can find the courage to try again and that she gets a more understanding gp this time, grr adult mental health services are useless! I know!!

  10. Oh, that poor lass. So praying..

    Kinga, I worry about some of what you’ve said – it seems as if it equates eating disorders with being somehow indulgent – something that comes out of people having time to worry about their weight or the way they look. I really don’t think that’s the case – in my own experience, my own issues with eating stem out of several different issues – and I’m sure that’s the case for the lady Emma spoke about. Regardless, the thing is, we’ll never know – and her courage in speaking out really was that – pure unadulterated gutsiness, that ought to have been recognised by the GP at least, even if there was little he could do.

    I’m not denying that we here in the West have some things very much easier. And I can imagine that in a place where food, or access to basic necessaties are difficult, issues over eating might seem difficult to understand. But they’re there, and they’re real, and believe me – they’re awful. They aren’t about being self indulgent, or selfish – if they were, I think the majority of sufferers would get bored and stop it after a while. The fact is they – we, can’t do that, at least alone.

  11. I hate hearing things like this. I also struggle right now. I had anorexia for years and years, and then recovered, but probably to the point of not being fully recovered, but functioning well enough, maintaining a slightly low BMI, but not a major issue day to day. Now I’ve run into a physical illness, and am struggling to keep my weight. I’ve got all kinds of malnutrition associated issues, and I keep telling doctors ‘I think its nutritional’ or ‘I’m having nutritional problems’ or ‘I’m getting scared to eat now because of the symptoms it causes (non ED symptoms)’. Nobody seems to hear me. I’m not sick enough. It is tempting to let it get worse, but even then, when will anybody notice enough to care? I never got sick enough before, even through all the really bad years. People can’t hear you. Until your BMI is about 14, I think they just don’t see or notice. How hard can you push to ask for help?

    (And I actually start to feel a little jealous of friends who have suspected cancers and things because they get taken seriously and get support and help. Is that really warped? Probably).

    Kinga, I hear what you are saying, but it isn’t just that way. I’ve had a child die. I’ve seen friends go through real awful difficulties. I spend a lot of my life in African countries, where like you say, each day can be about survival. It helps me gain perspective at times, but at other times makes me even more embarrased and ashamed that I can struggle with something so seemingly superficial, selfish and meaningless. I can rationalise it away in a second, but the thoughts can still be there. (But on the other hand I would agree. I get frustrated when people back here fall apart after something like the death of a baby when at the time when my child died I was living in a city where 1 in 2 women had a child die under the age of 5. Yes it was sad, yes it changed me forever, but it was not an excuse to fall apart. Maybe you know what I mean).

    I suppose its that EDs are not just about superficial things like appearance, size and weight. They are not about being self obsessed. They can be more complex than that, hence they are so hard to get truly free from.

  12. I actually blew a raspberry at this post.

    Emmas friend – i am so so sorry this happened. You were so very brave! well done for going and facing up to it! I’d encourage you to try again (can emma go with you?!) and keep holding on, you can do it. x

  13. In reading this I am struck with a couple things.

    First, is an eating disorder a disease or is it a behavior? Is it something I picked up from a toilet seat or was it a way of life resulting from of a certain way of thinking.

    Medical intervention is, I am led believe, the least successful and most expensive way to handle psycho-spiritual disorders. The exception being of course when a doctor has a deeper personal understanding of spiritual/mental/physical connections.

    As a teenager, secretly struggling with bulimia, I was seen for Shingles and a stress related rash on my face, and I was somewhat helped by the dermatologist. His advice was very helpful, but only because he was also a Christian and cared enough about me as a person to confirm my own beliefs that it was really a spiritual issue. It seemed to take the mystical power away from the disorder and hand it back to God and me. He also removed a wart from my index finger. Nice guy.

    The second point is related to the first in this: Doctors are human too, and have a great capacity for mental illness as well. They also each have a distinct worldview. If eating disorders are seen as a type of slow suicide, maybe certain doctors see that as good…like Ebeneezer scrooge.. “then let them do it, and decrease the surplus population!”

    I live in the USA and my particular state was one of the last to receive statehood so our laws are fairly liberal/secular humanistic. We embrace and protect suicide and abortion and prostitution and public drunkenness and drugs and gambling (working on it). Our medical attitude toward self destruction and the destruction of civility reflects our political stands.

    If there is any help around here, it comes from individuals (maybe churches) who value the individual because God values the individual . And we don’t even have socialized medicine yet!

  14. Just to say, sorry if I sounded a bit like I was having a rant yesterday. Its just so frustrating – that for years and years people close to us can say we shouldn’t be afraid to ask for help, should encourage us to do so, but then when we do, it can be like a huge slap in the face.

    Is it an illness? Or a behaviour? Or a sin issue? Or a choice? Can it be some of all of those things?

  15. Oh dear, a horrible experience…. Very odd that the GP asked her what she saw when she looked in the mirror as though to check whether she had body dysmorphia and then when her answer reflected body dysmorphia responded as though he didn’t believe in it/understand it!

    Would it be worth finding out what the provision for eating disorders is in this lady’s area and contacting them to find out who they accept referrals from and what their criteria are?

    Agree with others about finding a more sympathetic GP.

    I have found it helpful in the past to write down my questions/points I want to get across before a medical consultation – this can help you to stick to your guns and get what you need from the consultation even if the dynamic isn’t quite what you wanted or you find yourself getting upset. Also I would strongly recommend she find someone she can bring with her that she trusts who can support her at the consultation. Ideally someone who can fight her corner in such a way as to gain/retain the GP’s sympathy rather than making them feel ganged up on as well as just being there for moral support.

    Has she contacted the Helpline – have they been able to point to a way forward for her?


  16. thanks so much for all of your comments. We’re gonna go back to a different GP and jump up and down. If that doesn’t work, we’ll try another surgery.

  17. Hey Emma x
    So glad that you guy are gonna try a different GP. The guy she saw before is evidently completely clueless. A harsh judgement, but all I can really put that sort of reaction down to.

    Kinga. I don’t know quite how to respond to your post. I think I’m both a little offended, and a little interested in your comments.
    What is the percentage of ED in your country? Is it something that doesn’t really exist? Something that doesn’t get diagnosed? Or something that is just not acknowledged ?
    My anorexia began when I turned 30.
    It has, in a short space of time, pretty much destroyed me. I now have no income, no prospects (for the time being), no relationship… and know what? I never look in the mirror.
    It’s not about how I look. i don’t care about that.
    To imply that anorexia is about indulging vanity is like saying that cancer is about indulging a desire for attention…
    Still. I am interested in what you say… Perhaps anorexia is a ‘western’ or ‘rich kid’s illness’.

    Just some thoughts.

  18. Sadly I am not surprised by this. When I finally plucked up courage to visit my GP for help with the same problem, I said, ‘I think I have an eating problem’, his words were : ‘too much or too little? I can’t tell’…

    I can’t tell you how much it had taken for me to even go there in the first place. Much persuasion had taken place on behalf of one friend in particular.

    I left in tears and I never saw the GP again. Interestingly I had also seen him some while prior to this about food intolerances. He told me I had IBS and to go away and deal with it. It was only on moving house and finding a new, and lovely lady GP, that I got help.

    I know this chap has now retired and I hope with him, many of his cohorts with the same stuffy, outdated and stuck up attitudes…

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