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How to support an employee with an eating disorder

Practical ways to help someone with an eating disorder thrive at work

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What is an eating disorder, and who's affected?How might an eating disorder affect someone at work?How to manage someone with an eating disorder in the workplacePractical tips to support a colleague with an eating disorder

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In 2021, the Royal College of Psychiatrists warned that the UK would face a hidden epidemic of eating disorders in the aftermath of COVID-19. For people who have used food as a way to feel more in control during long periods of home working, job insecurity, scary global events and isolation, it’s natural to feel extra vulnerable as the world opens back up and the communal coffee round starts again. 

Recognising an eating disorder in a colleague can be tricky (especially over video call). But nurturing an open culture around mental health can go a long way towards helping someone who’s struggling with an eating disorder to confide in you as a manager or team leader. Once they do, there are some low-cost ways to help them feel more comfortable at work.

Who’s affected by eating disorders?

Although pop culture would have us believe they only affect young women, absolutely anyone can experience an eating disorder. Most people with eating disorders are adults, and about one in four identifies as male. In fact, eating disorders affect about 1.25 million people in the UK, which accounts for 9% of people with a mental health condition overall. That’s a huge number of people whose quality of life is affected at work, day in, day out.

What is an eating disorder?

The NHS defines an eating disorder as ‘a mental health condition where you use the control of food to cope with feelings.’ For the person suffering, it can feel like an overwhelming, all-encompassing fixation on food or body image that can stop them being able to focus on or enjoy other aspects of their life, including their relationships with other people.

Common types of eating disorders are:

Bulimia nervosa

– where somebody binge eats compulsively and then purges food from their body via vomiting, excessive exercise or laxatives.

Anorexia nervosa

– where somebody develops a fear of gaining or maintaining weight so they eat too little and/or exercise too much. (Sadly, anorexia has the highest mortality rate of any mental illness.)

Binge eating disorder

– where somebody feels compelled to overeat on a regular basis.

Avoidant/restrictive food intake disorder (ARFID)

– where somebody avoids certain foods or types of food (usually unrelated to concerns about their weight).

Other specified feeding or eating disorder (OSFED)

– an umbrella term for other mental health problems related to eating that may not fit the expected symptoms for other conditions, or aren’t yet recognised as a specific disorder. That last category includes things like night eating syndrome, orthorexia (an obsessive focus on healthy eating) and pica (eating things that aren’t considered food).



There isn’t a single cause of eating disorders, and it’s likely that a combination of genetic, biological, psychological and cultural factors are at play. Using food as a coping mechanism can be triggered or worsened by stress, anxiety, low self-esteem or basically any situation where somebody feels like things are out of their control. 

The effects of these mental health conditions are complex and long-lasting. People experience anorexia for eight years on average, and bulimia for five. Though serious, recovery from an eating disorder is entirely possible with the right professional support.

How might an eating disorder affect someone at work?

Like any mental health condition, there isn’t a simple checklist to recognise someone you work with is struggling with an eating disorder. Outward signs like weight fluctuations may – though not always – become apparent, but you’re more likely to spot changes in someone’s mood and behaviour first. Plenty of people continue to excel in their role while dealing with an eating disorder, while others simply won’t be getting the nutrients or sleep they need to stay alert at work. 

Eating disorder symptoms to look out for in the workplace:

  • A preoccupation with food, weight or dieting
  • Emotional outbursts 
  • Difficulty concentrating on tasks or conversations
  • Scheduling work events around exercise 
  • Coming in late or lethargic
  • Excessive coffee consumption
  • Social withdrawal
  • Not wanting to be on video during calls
  • A resistance to change
  • Getting minor illnesses like colds more often, and taking more sick days 
  • Making excuses to avoid mealtimes or social events where food is present
  • Persistent low mood
  • Feeling cold


Tragically, the shame that surrounds disordered eating means that people will often make a huge amount of effort for it to go unnoticed at work.

As a manager, it’s important to start an open conversation with your colleague if you spot symptoms that concern you – but be mindful that they may not be ready to disclose or discuss any mental health issue with you. Lots of people also might not recognise that they are experiencing an eating disorder themselves.

Make sure your employees get the support they need with next-day access to Spill therapists.

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How to manage someone with an eating disorder in the workplace

If a team member you manage discloses an eating disorder that’s affecting them at work, the most important thing you can do is listen. It’s important that you understand how the condition is affecting them professionally, and what they might need to make them feel more comfortable on the job.

As well as being an empathetic organisation who wants everyone to feel happier and healthier at work, your workplace is legally obliged to make reasonable adjustments for anyone with a long-term mental health condition. That means adapting someone’s workplace, schedule or environment so that they aren’t put at a disadvantage compared to their colleagues. 

You’ll find some ideas for practical changes in the next chapter, but the key thing is to ask the person experiencing an eating disorder what might help them to feel empowered and productive at work. It might be a more private place to spend lunchtimes, taking shorter but more regular breaks or a more flexible working pattern. You won’t need to know the specifics of their disorder to do this, so don’t push them to share any details that they don’t volunteer.  

And remember, you don’t need to have all the answers right away. The fact that they’ve approached you is a really positive sign. It’s not your responsibility as a manager to diagnose anybody with an eating disorder, and it’s not appropriate to suggest they seek treatment, either. What might be helpful is to remind your colleague about any company policies that could affect them, and how to access any mental health support or therapy that your business offers (like an EAP, or Spill). They don’t need any official diagnosis to seek professional support.



It’s also a good idea to block out some time in any ongoing one-to-ones to talk about how they’re feeling at work, and whether any further adjustments would be sensible. 

Practical tips to support a colleague with an eating disorder

👉 Accommodate flexible working, if you can

People with eating disorders might need time off work for medical appointments or talking therapies. Mental health conditions can also severely impact energy levels and sleeping patterns, so starting and finishing work an hour later might be a small change that’ll make a big difference to someone’s mood and productivity.

👉 Be thoughtful with your conversation topics

  • Avoid commenting on what people are eating, and try not to call the chocolate biscuits for your meeting ‘bad’ or ‘naughty’. 
  • Negative comments about your own body image aren’t great for your self-esteem, but they can also be really damaging for anyone in earshot with an eating disorder. 
  • Hearing about gym routines, exercise schedules or running milestones can be triggering for anyone whose symptoms include over-exercise or calorie-counting. 

👉 Arrange socials that don’t involve food

Make sure to include everybody on social invitations, but be mindful that team dinners or parties might be too stressful for somebody living with an eating disorder. Consider organising an alternative team bonding activity, instead. Mini golf, anyone?

If entertaining clients over lunch is a regular occurence, ask your colleague if they would rather hand this responsibility over to somebody else in the team. 

👉 Don’t comment on someone’s appearance

Even seemingly harmless phrases like ‘you look well’ or ‘you look healthy’ can spark difficult feelings for someone with disordered eating. 

👉 Consider whether your workplace culture or environment encourages bad food habits 

This might be the case if everybody in your team stays online to eat lunch al-desko, or if the only food available to buy in a mile radius of your office is a Kit Kat from a vending machine. Adding more choice and variety could benefit all employees, not just those with an eating disorder. 

👉 Reinforce positive feedback loops

Any mental health condition can have a negative impact on someone’s self-esteem. Find little ways to let them know that you value them and their work. It’s a good idea to praise people in writing and in public (think a Slack post or a team email), so they get the added emotional payoff of feeling respected and recognised by others.

Treatment for eating disorders

Because the control of food is a coping mechanism, many people see their eating disorder as the answer to managing difficult emotions, rather than the problem. That means it can take a long time to seek help.

Mental health charity Mind has an excellent summary of the treatment options available for eating disorders. A tailored treatment plan might include:

Therapy

Anyone who experiences a complicated relationship with food may benefit from talking therapies. A particular kind of therapy called CBT (cognitive behavioural therapy) can help people with eating disorders to recognise harmful thought patterns around their body or food in general and challenge the associated behaviours. 

Medication

A doctor might prescribe antidepressants or mood stabilisers to alleviate the symptoms of other mental health conditions like anxiety, depression or obsessive-compulsive disorder. 


Inpatient treatment

A hospital stay might be necessary to help someone manage their weight back to a healthy level through a process called ‘refeeding.’ This happens with the support of specialist doctors, social workers, therapists and dieticians. 

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When, how and if your colleague seeks treatment is a very personal decision, but we hope that this guide helps you to feel a bit more prepared if someone in your team discloses an eating disorder that might be affecting their health and happiness at work.

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