Table 4.
Themes and Illustrative Quotes of Weight Stigma in ED Treatment
| Weight Stigma in ED Treatment |
| Provider Encouraged ED Behaviors |
| Marie: She [provider] was really toxic for my ED… she ended up giving me a diet book… because she thought that if I was more comfortable with what I was eating, that I would eat |
| Cabaletta: I go back, and he’s [doctor] like, “you need to lose weight” and there’s like this constant cycle of, like, losing weight versus not using an ED. |
| Joanna: The interaction after I just said, “You know I am not sure how to hold your food restriction advice with the fact that I’m in recovery from anorexia. I don’t know how to hold both those.” |
| Provider Minimize or Deny ED |
| Marie: I said, “I have an ED.” And she looked at me. She said, “You don’t look like you have an ED.” |
| Grace: When I started becoming eating disordered later, I don’t think I was taken seriously. |
| Beth: All… others were kind of either overlooked or glib or didn’t understand the ramifications of what the disorder does or doesn’t do. I would say… it’s been mostly negative. |
| Misdiagnosis and Missed Symptoms |
| Layla: I was diagnosed with compulsive overeating during one of my most restrictive points. |
| Jessie: Even when I was diagnosed with bulimia, okay… that wasn’t really accurate, because I wasn’t really bingeing, but they assumed, “this fat person must binge.” …the advice was “you shouldn’t do that ‘cause it won’t help you lose weight.” |
| Jen: [My body size] had everything to do with it. “I wasn’t in any medical danger” or if I was, it wasn’t looked for. |
| Weight Stigma Experiences at Higher Levels of Care |
| Abby: [In treatment] People were treated very differently because they were at different weights. |
| Joanna: Other folks making statements about there being a limit on how much weight someone should gain before it becomes a “problem.” |
| Lexi: In a lot of ED treatments, you get in higher levels of care, the milieu or care staff is often new or less educated around EDs and can sometimes just make stupid comments. |
| Systemic Issues of Weight Stigma in Healthcare |
| Bette: [if I were thin] I think that I would’ve been able to get PHP, and I would be able to stay in it longer... |
| Lynn: The ED behavior started coming back, I was exercising significantly more… she wanted me to go back to residential… My insurance was trying to cut me to IOP. |
| Michelle: I wish [my insurance] hadn’t sent me home. The conversation about suicide and the hospital, disclosing [the abuse], having to move to an apartment by myself, and stepping down to IOP all happened in the same week. How can you hear all of that and still shove that client to a lower level of care? |