A coffee break revelation

5 minute read
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Module one of my Executive Masters in Global Healthcare Leadership at Oxford promised an exciting academic journey. Little did I know that the real gems would be the connections forged within my cohort. One particular connection with the vibrant psychiatrist Urvashnee Singh, aka Vash, added an unexpected layer to my experience.

Discovering that Vash was in the midst of establishing an eating disorder centre in Australia, I took the opportunity during a casual coffee break to express my connection with her mission. I shared that I had recently overcome a binge eating disorder myself. Vash, with a hint of nonchalance, dropped a bombshell, 'Oh, I am not surprised at all, I would’ve probably guessed it actually.' I was puzzled. As a woman of average weight, my mind sprinted through a series of questions. Could she see it on my skin? Did she catch me in the act of munching on snacks? The perplexed look on my face prompted her to delve further, 'It’s quite common with intelligent and highly achieving women.' All of a sudden, my confused frown turned into a smile. I was proud to belong to this group of women. I wasn't just a woman who conquered an eating disorder; I was part of a league of intelligent women grappling with scientifically proven side effects. I’m unsure if Vash had this intention in mind, I’ll await her feedback after sharing this blog.

Unveiling the complexity of binge eating disorders exposes a silent companion - shame. It goes beyond mere overindulgence. In fact, it's a tangled web of guilt about gaining weight, lacking discipline and the perpetual struggle for self-control. Imagine a binge eater trying to navigate their eating patterns by self-imposing dietary restrictions, captivated by the forbidden allure of 'unhealthy' treats. In an act of rebellion against their own rules, they plunge into a cascade of indulgence, searching for comfort, fulfilment and paradoxically, self-inflicted guilt.

The mind of a binge eater is a battleground of conflicting thoughts. Enter the 'what the hell' effect, a cunning mental twist where nibbling on a single cookie becomes a slippery slope. Why stop at one when the rule was already broken? Then there's the 'last chance syndrome,' a solemn promise that this is the final rendezvous with cake, only to devour the entire confectionery masterpiece. In a desperate attempt to shed the gained weight, binge eaters often embark on the futile mission of simply trying to 'stop eating' – a seemingly impossible task for mere mortals. This endeavour sets the stage for a relentless cycle of guilt. Welcome to the world of positively reinforcing loops – where each bite magnifies shame, raises the bar of impossible targets, and the cycle perpetuates itself.

Fast forward to the present as I’m diving into the pre-reads of Module three about complex systems. I’m extremely inspired by some excellent system analogies provided by the late Donella Meadows. Picture this: a bathtub brimming with water, threatening to overflow. Now, our natural instinct might be to focus on the cascading water, desperately trying to contain the imminent flood. Meadows challenges us to redirect our attention to the less obvious - the root cause which is the metaphorical tap that controls the water flow. The more intricate the system, the trickier it becomes to pinpoint this tap, which we call a 'leverage point' when it comes to Systems Thinking.

Navigating my binge eating disorder felt like trying to control the overflowing water - an impossible task. What if the real tap to turn wasn't counting calories but addressing the deep-seated shame surrounding body weight and eating habits? My genuine healing started when I accepted my condition as a product of life's unpredictable circumstances. I ceased blaming myself, recognizing the role of genetics, upbringing and life experiences. The road to recovery was long and difficult, involving self-understanding and a commitment to self-love.

Vash's comment, though received post-recovery, was a comforting revelation. It made me reflect on how much faster my healing could have been with earlier acceptance - less self-judgment, guilt and shame. It left me wishing I made this encounter during the darker days of my struggle. Now, I'm not saying you need to enrol in a Master's program to find your own 'Vash,' but hey, not a bad idea, right?

Imagine if we flipped the script on how we view 'disorders'. What if they were mere side effects of traits that we admire or feel neutral about as a society? What if eating disorders are more common for intelligent people the way cancer is more common for tall people [1] [2] [3]? What if we approached those battling their daily food struggles with the same empathy we reserve for cancer patients? Trust me, both can feel equally out of someone’s control.

We're in need of a mindset makeover. To revolutionize society's views on eating disorders, institutions can take the lead by rebranding struggles with food, and offering scientific evidence linking them to genetics or traumatic experiences.

In case you think this article doesn’t involve you, let me tell you why it does. Those snarky comments about someone's weight you might casually accept? You're unwittingly feeding a system that deepens their shame, fuelling destructive eating habits.

Perhaps the biggest 'tap' that we need to close is the judgements that we have for others. True empathy, woven into the fabric of our society, may be the leverage point to unlock most systems.

Oxford MSc in Global Healthcare Leadership
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References
[1] Lopez C, Stahl D, Tchanturia K. Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature. Ann Gen Psychiatry. 2010 Dec 23;9:40. doi: 10.1186/1744-859X-9-40. PMID: 21182794; PMCID: PMC3016382. Available on: this link.
[2] Schilder CMT, van Elburg AA, Snellen WM, Sternheim LC, Hoek HW, Danner UN. Intellectual functioning of adolescent and adult patients with eating disorders. Int J Eat Disord. 2017 May;50(5):481-489. doi: 10.1002/eat.22594. Epub 2016 Aug 16. PMID: 27528419. Available on: this link.
[3] Ong JS, An J, Law MH, Whiteman DC, Neale RE, Gharahkhani P, MacGregor S. Height and overall cancer risk and mortality: evidence from a Mendelian randomisation study on 310,000 UK Biobank participants. Br J Cancer. 2018 May;118(9):1262-1267. doi: 10.1038/s41416-018-0063-4. Epub 2018 Mar 27. PMID: 29581483; PMCID: PMC5943400. Available on: this link.