Sarah Cox was admitted to hospital and placed on a feeding tube because she was malnourished, yet hospital staff discharged her with a weight loss plan. “I was told: ‘You’re still overweight, you still need to lose weight.’”
Cox says her eating disorder began after she was told by her GP to lose weight and that her body mass index (BMI) was too high at every appointment she attended throughout 2018-19, despite displaying no indicators of poor health such as blood test abnormalities or high or low blood pressure.
Cox remembers raising concerns with her GP about the diet after she passed out multiple times and being told: “You are still overweight. You need to ramp it up, not ramp it down.”
In 2020 Cox developed atypical anorexia, an eating disorder with all the same symptoms as anorexia except the person never becomes clinically underweight. Between 2020 and 2021, Cox was admitted to hospital more than 10 times.
Experts in diet and nutrition say cases such as Cox’s reveal why health, not weight loss, needs to be the focus of public health messaging, but that dietary guidelines from government bodies are doing the opposite – contributing to eating disorder risk.
Cox says when she was treated by one of the chief psychiatrists in eating disorders for Queensland, he told her she would never have developed a disorder if medical professionals had not put so much pressure on her to lose weight.
Dr Fiona Willer, a dietitian and lecturer at the Queensland University of Technology, says the primary risk of developing an eating disorder comes from trying to change one’s weight, yet it is a message reinforced by some doctors and health departments. “Everyone’s saying, ‘if you’re larger-bodied, you should try to be smaller-bodied’.”