Why Are So Many Nutrition Students Struggling With Eating Disorders?

Published August 24th, 2017

https://www.vice.com/en_au/article/padj4g/uni-doctors-talk-about-the-worst-student-diets-theyve-seen

In 2012, an international study in 14 countries found a whopping 77 percent of nutrition students felt that eating disorders were a concern among their peers. The reasons behind this are complicated. Theories run from an obsessive overexposure to information about food and exercise, to pressure within degrees to be an “ideal nutritionist.” But the key word here is theory, because there actually hasn’t been any research linking a particular area of study with mental health.

To try and understand what’s going on, VICE spoke with four people who are involved with nutrition and dietetics education. We wanted to know whether they had seen an unusual incidence of eating disorders among their peers and students firsthand. And have they suffered themselves?

Dr Sarah Harry
Psychotherapist specialising in eating disorders and body image, lecturer in body image and counselling skills for dietitians

VICE: Hi there Sarah, what would make someone studying, say, nutrition vulnerable to disordered eating? 
Sarah Harry: Look, it’s important to note that the courses themselves aren’t causing eating disorders. But what I’ve noticed anecdotally is the people who’re already vulnerable or highly interested in the nuances of diet are developing problematic relationships with food. We really stress that if you have any issues in this area you need to get these addressed before you start treating patients because otherwise it’s unethical.

Have you met any nutrition students who have disordered eating?
Every year in every course, people come forward. I’ll often get five emails from dietetic postgraduate masters students. The stories themselves are confidential, but we’ll talk about their current and past relationship with eating, body image, and how they feel about the pressure of being a dietitian in the current society.

Are there any patterns you’ve noticed among those students?
There’s the pressure of the “typical dietetic body,” which feels strongest amongst students, especially those who aren’t typically “small.” We tell them that practising dieticians have many different bodies and that it doesn’t affect their career.

Is enough being done to address this? 
It’s still an issue, but there’s been a huge amount of progress in the last two years where we’re seeing this be addressed across all universities in Victoria. In an ideal world, I would love more time to discuss this with students and we would like to be more prevalent among universities who’re dealing with body or eating disorders in general.

Courtney
Qualified dietitian, who developed an eating disorder during her studies

Hey Courtney, can you talk me through your story?
So halfway through my degree I got into the clean eating movement, which spiralled into something unhealthy and obsessive. I had this fear that I wouldn’t be the nutritionist who is slim, fit, and eats healthy. I didn’t fit into anything related to an eating disorder according to the DSM [Diagnostic and Statistical Manual of Mental Disorders]. But was I healthy? Absolutely not.

What do you think created this problem?
I remember times I’d be at a bar, or at someone’s birthday, and I’d mention to someone that I was studying nutrition. After that, the same questions would come. “Why are you drinking?” and “Why are you eating cake?” There’s this sense that if you’re a nutritionist there’s a right way to be, and a wrong way to be.

Was this sense prevalent among the other students? 
There’s definitely this undertone of the right and wrong way to eat. I was one of two students who would have a sandwich for lunch and I would get the oddest looks. Everyone else was just eating high protein salads. I remember another time talking about cooking brownies and using real sugar. People looked at me in disbelief. No one ever came up to me and confronted me, but there was this feeling that I was doing something wrong.

I don’t remember the faculty addressing it, whatsoever. There were free counselling sessions, but nothing specific for disordered eating. The problem with this is that when eating disorders are discussed, people go straight to the clinical disorders—so anorexia nervosa and bulimia nervosa—and what that means is there are a whole lot of people, like me, who don’t meet that criteria. It’s just seen as something normal because that’s what you do when you’re a nutrition student

Is that grey area why it’s not being taken seriously? 
No one’s coming forward. If you sat down 50 nutrition students, not one of them would put their hand up and admit they had a problem. Because it’s food. And we’re experts in food. There’s such a stigma. The bad thing is, if this isn’t addressed, dieticians and nutritionists go out into the workforce putting that onto their clients.

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Delilah*
Nutrition student, who’ s been experiencing anorexia nervosa and disordered eating for 13 years

Hey Delilah, considering your condition, what’s it been like studying nutrition?
I’ve found there’s this sense that your weight and appearance is integral. It’s really common for people in my course to talk about how no one would see a fat nutritionist. No one’s brought it up my diet or behaviour with me either because I’m a nutritionist. There’s no sense that this may be because I have an eating disorder.

Do you personally feel pressure to be skinny? 
Absolutely. Every time I consider working in a private practice, I think to myself: Who’s going to see a nutritionist that’s size 12? Everyone thinks in order to be slim, you need to be healthy and to be healthy, you need to go see a nutritionist and to talk about nutrition, you have to “look the part.”

Do you think this pressure on nutritionists is self-imposed?
No, it’s pressure coming from society as well. I remember once, a dietitian who looked large on the social media profile received such an onslaught. People said things like” she’s too fat” and “she isn’t a good dietitian.”

Have any other students opened up to you about their own struggles with food?
No one’s mentioned it to me. But I do remember one time this girl baked banana bread and left it in the communal room for everyone, but no one touched it.

Dr Rebecca Reynolds
Registered nutritionist, lecturer at UNSW

As both a nutritionist and a lecturer, what are the causing factors that influence a nutrition student to develop disordered eating? 
It’s important to note that not everyone who studies nutrition or dietetics is going to develop an eating disorder. But from what I’ve seen, there’s often an attraction because of pre-existing conditions.

Have you personally seen nutrition students suffer? 
Yes, a lot of my students have an obsession with “healthy eating.” I remember teaching at Sydney University and I had a girl who was bronzed and slim and put 10 nutrition supplements on her paper. Another time, a student in my course contacted me about her excessive exercise routine and very strict diet.

Is there a sense of responsibility as educators to provide for your students?
There are some really great nutrition leaders, but unfortunately there’s also some not-so-great ones who aren’t promoting a balanced lifestyle. In my course, we have content and activities about eating disorders in mine and share my own eating disorder experiences with my students and allow an open door for them. For me, providing that support is vital.

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