ED and Medical Education

Throughout my studying, I noticed that very little information is available to students about ED. In elementary school, the focus of health teaching was on nutrition and how to avoid obesity. We hardly mentioned anorexia or bulimia. But what about in nursing or medical education in universities? Is it included? In my experience, not very much. Now, I know that obesity may seem to be more of an epidemic, but does that mean that we should not learn about ED and how to help our patients? Maybe it will be covered in a 'mental health' setting as opposed to general medical information. Bur I still feel that it should be given its time. As well, when ED is mentioned, I still believe that people are not getting the facts right. Let me explain...

One of my nursing textbooks (this is a paraphrase, not direct quote; nonetheless, the message is essentially the same) says that anorexia is a 'disease where young women feel overweight when they clearly not. They are irrational and perfectionist. Often dying from lack of body fat and nutrition, this girl typically is not engaged in sexual relationships and does not usually associate with others. She is preoccupied with food and weight, and this impairs her social life. Research shows that causes of anorexia nervosa are: having an unsteady relationship with one's mother, having overprotective parents, and not being permitted to express emotions in the family unit'. (I will not quote wher this is from out of respect to the authors, who honestly do a great job of explaining all other diseases - except for anorexia and eating disorders).

Do you spot the problem with the text? First, not all patients are 'irriational'. Yes, the fear of gaining weight may not seem proportional to the issue at hand, but it is a REAL fear because ED is a MENTAL illness. Calling patients irriational is, in my opinion, a bit harsh. Now, what about not being engaged in sexual or other relationships? There are MANY ED victims who are in a sexual relationship - it is not right to assume that their ED stops this from happening. And the social part? I was sick with ED and has lots of friends, and I spent a lot of time with them. Yes, ED may hinder some parts of our social lives, but it does not mean that we are loners. Lastly, the causes that they list are not supported by evidence. Maybe some people with ED have the above characteristics, but until now, no UPDATED and SUPPORTED research has shown that having overprotective parents or a bad mother causes ED. To blame a mental illness on such things is, in my opinon, unfair and biased.

What should we learn in medical school or nursing education? That ED is a MENTAL or psychological illness with many different causes and triggers, but no one thing solely causes it. In fact, a mix of genetics, brain chemistry, hormones, social amd personal factors interplay with one another. ED is also serious, and it is life-threatening. To characterize patients as perfectionist and irrational may be applicable to some patients, but maybe it would be more appropriate to say that patients with ED are usually perfectionist, and due to their mental illness (which they cannot control), they fear gaining weight and being fat. Finally, we need to focus on how ED should be treated and how we can help patients. Food is medicine, but so is therapy and expressing emotions. Helping the patient regain their lives that they lost due to ED is critical. Understanding and helping them see that they are victims and not the cause for their disorder is of the upmost importance. Not blaming the patient is NUMBER ONE.

Like with many mental illnesses, we still have a long way to go before medical education perfectly explains what ED is and how we can help our patients. We get so focussed on learning and teaching about other disorders like heart disease, kidney failure, diabetes, etc that we forget that mental health is deadly and serious as well. I think it's time that we put aside these wrong patterns of thinking and start to realize that as medical professionals, we need to learn about the other diseases that patients may present with - mental and emotional illnesses that require time, healing, trust, and empathy.

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