I grew up as an athlete, playing competitive basketball and soccer on school and community teams. I never thought much about my body or what I ate until I tore my anterior cruciate ligament (ACL) in 2015 while playing basketball. During the rehabilitation process after my knee surgery, I committed to a rigorous physiotherapy routine and felt compelled to go to the gym every day. I desperately wanted to be back with my teams as soon as possible, and as a result, found myself absorbed into a vicious routine of fitness and dieting. I thought I was making healthy choices, however, those choices, along with pressures from social media, soon began to dictate my life.

I believed that restricting certain foods made me healthy. It wasn’t until I saw a dietitian, however, that I realized that I lacked the control to allow myself to enjoy eating what I used to love. I felt labelled; I felt trapped in a lifestyle I had no control over. I did not think that my peers would understand. But, as I shared my experiences with others I met when I arrived at McGill, I realized that I was not alone.

Howard Steiger is the director of the Eating Disorders Program (EDP) at the Douglas Mental Health University Institute. His research focusses on how one’s environment influences the genetic factors that play a role in the development of eating disorders. Steiger provided a general description of what disordered eating looks like.

“Broadly, eating disorders have to do with intense preoccupation with eating, weight, body image, control of weight, [et cetera],” Steiger said. “These preoccupations shape or motivate problematic behaviours.”

According to Canada’s National Initiative for Eating Disorders (NIED) that data from Statistics Canada shows that approximately one million Canadians meet the diagnostic criteria for an eating disorder, such as anorexia Nervosa, bulimia nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, or Other Specified Feeding and Eating Disorder. Steiger explained that women are more prone to disordered eating due to sociocultural and biological factors, though he emphasized that those from all backgrounds can develop an eating disorder.

“We do not think in terms of stereotypes,” Steiger said. “It is not just the young adolescence [or that] young girl in high school [….] [Eating disorders can occur] in all age groups [….] The peak age for [developing] anorexia is 28, and people can develop or maintain an eating disorder right throughout their life cycle.”

As I rehabilitated my knee, I became fascinated with the workout routines and meals of various fitness influencers and immersed myself in their social media feeds. I compared myself to the perfectly sculpted bodies I saw online and forced myself through grueling workouts while restricting my diet to foods I considered healthy.

A study published by the International Journal of Eating Disorders in December 2019 showed that more daily time spent on Instagram is associated with significantly higher Global Eating Disorder Examination-Questionnaire scores (EDE-Q). The EDE-Q is a well-established tool used by researchers and clinicians to measure disordered eating behaviours. While Steiger acknowledged that social media can help spread helpful messages to those struggling with body image, he believes that online platforms are a double-edged sword.

“Many of us working in this field work through social media […] to get out helpful messages, education, and prevention programs,” Steiger said. “[Social media] can have wonderful effects but anything strong enough to help is probably strong enough to hurt. [Social media] is full of very sexualized images of bodies [and] people presenting themselves as scantily clad. [There are] lots of thin body images, photoshopped and made up […] which means that people are increasingly and more constantly forced to compare themselves to not very attainable standards.”

To Steiger, it is important to help those struggling with disordered eating to realize that it is not their fault.

“There is a whole literature [about using] an epigenetically informed view, with the idea that if you got an eating disorder, it is not moral weakness and it is not because you are stubborn, [but] because you carry a real susceptibility that got turned on by your life experiences,” Steiger said. “When therapists talk that way, it is shown to reduce shame and stigma and to increase optimism about recovery. People feel shame [about eating disorders] and it helps to see that it is not because [they are] weak and stupid.”

Steiger often tries to show his patients that they are not always the ones to blame for developing an eating disorder.

“I often say to my patients: ‘You were walking on the sidewalk when the movers dropped the piano,’” Steiger said.

This analogy accurately depicts a moment in my journey as an athlete. I was injured but well on my way towards recovery when my life changed without notice.

Belle Sullivan, U3 Arts, is the campaign coordinator at the Students’ Society of McGill University (SSMU) Eating Disorder Resource and Support Centre. This student-run resource centre provides peer support programs for McGill students seeking help with disordered eating. The centre also advocates for increasing resources and raising awareness around this area of mental health. Sullivan described how the high-pressure environment of university can trigger disordered eating.

“Everyone is under a lot of stress all the time,” Sullivan said. “[University] is just such a stressful place, which is something that makes people vulnerable. Especially [when] living a precarious student lifestyle, it can be easy to develop [disordered eating] and have it come back without them being noticed and addressed.”

Moving away from home for university can also be a traumatic experience for those struggling with disordered eating. Sullivan echoed the difficulties that I faced when my routine was disrupted upon arriving at New Residence Hall for my first year at McGill.

“For a lot of people, […] it’s their first time living away from home,” Sullivan said. “Obviously, it’s a massive change [and] a really new environment. That’s a situation that can be very triggering of all kinds of mental health issues but eating disorders especially. The residence environment can be difficult to navigate for someone with these issues. Things like dining hall food, the availability or lack thereof of certain types of food [and] the social environment of eating in the cafeteria with everybody […] are all things that can create issues for people struggling with these problems.”

The SSMU Eating Disorder Resource and Support Centre will campaign for a fee levy from March 17 to 27. The levy will support them in obtaining more institutional knowledge and resources from both the provincial and federal governments. For now, the support centre uses its resources to challenge the stigma around eating disorders and provides a safe space for those who want to talk about their experiences.

“[We heard feedback] from a lot of people during eating disorder awareness week and panel discussions [...] that it was nice to come to a space where it was safe to talk about these issues [and] also that they are treated as serious issues and people are able to talk about them in a serious way,” Sullivan said.

There is important value in a safe and comfortable place to discuss these issues, such as a psychotherapist’s office and in group discussions. Marie Grassia is a psychotherapist providing individualized and group therapy at the BACA Eating Disorders Clinic in downtown Montreal. She highlighted some of the strategies she uses and the goals of some of her cases.

“It does depend on the type of eating disorder that they have but typically for anorexia and bulimia, cognitive behavioural therapy (CBT) is considered the gold standard,” Grassia said. “We are really working on reducing restrictions and increasing [their] exposure to [...] ‘scary’ foods, ‘scary’ amounts of food [and fear of] weight gain. It is really about facing fears and being able to tolerate the anxiety that goes with that.”

When I reached out to McGill’s Eating Disorder Program (EDP) for support near the end of the Winter 2017 semester, I had the opportunity to share my story with a therapist. However, when I returned for school in the fall, the program had been cut. I was looking forward to properly addressing my eating patterns and felt alone again without support from the EDP.

Dr. Vera Romano, director of the Student Wellness Hub, explained that students seeking help with an eating disorder can now meet with Hub physicians, psychiatrists, dietitians, Local Wellness Advisors and counsellors to discuss their needs. Romano described some of the strategies used by therapists at the Hub.

“We […] offer a specialized psychotherapy group (students must be referred into the group by a Hub clinician) called Building a Healthy Body Image, which uses [Cognitive Behavioural Therapy (CBT)] and other techniques to help students explore their relationship to their body and identify healthy and unhealthy behaviours,” Romano wrote in an email to The McGill Tribune. Romano also referred to online resources such as the Virtual Hub’s Healthy Eating page and a list of off-campus resources for students who want additional treatment options.

University bureaucracy made it difficult for me to reach out for help, so I stopped: I was exhausted from sharing my story over and over again with therapists, dietitians, and pediatricians who were all strangers to me. I found that my friends, who encouraged and listened to me, became the best support system I had throughout my journey.

Everyone’s recovery process is different and I am curious if psychotherapy techniques such as CBT would have helped me should I have committed to receiving professional help. Grassia explained how CBT works to address the thoughts and emotions of those experiencing disordered eating and ultimately leads to a change in behaviour.

“CBT is a type of therapy where we focus on the relationship between thoughts, emotions and behaviour,” Grassia said. “So, being able to pay attention to the type of thoughts that may lead you to engage in behaviours that may be furthering an eating disorder.”

My busy schedule at university has directed me away from the vacuum of social media. As I developed new friendships, delved into scientific research, and discovered a passion for student journalism, I found meaning beyond the superficial glamour of social media.

“It is never appropriate to give up hope,” Steiger said.

For those who would like help from the SSMU Eating Disorder Resource and Support Centre, they offer drop-in support on Tuesday 5:30 pm – 7:30 pm at 3847 rue Peel and Fridays 6:00 – 8:00 pm at 688 Sherbrooke St. West Room 243. They can be reached at [email protected].