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Cancer and Eating Disorders

Posted 8/14/2015

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  This is a rather quirky topic, but one that interests me and may be of interest to some of you. In all honesty, I will admit that I have very rarely thought about or talked with my patients about eating disorders. On the one hand, I am far from an expert on that topic, and, on the other, it usually does not seem relevant. When, in speaking with a new patient and taking a history, there is mention of an eating disorder or a pattern of related issues then it has become a conversation. Most recently, a woman whom I have known for some time, and who is safely past her treatment, admitted that she has intermittently struggled with bulimia, and that it was again a problem.

  This essay from The New York TImes speaks more of anorexia, and the surprising pleasure that someone may have with cancer/treatment-related weight loss. This all feels to me to be something like domestic violence--meaning that, just because someone has cancer, it does not mean that she may not have other pre-existing problems, too. Just as I listen for hints about safety, I should also listen for hints about eating disorders. And now I will.

  Here is the start and a link:

When Cancer Triggers (or Hides) an Eating Disorder
By Sophia Kercher

As Kathleen Emmets was undergoing cancer treatment in New York over the past few years, her weight
began to drop. Even though she was often nauseous and paralyzed by chemotherapy-induced neuropathy, she joked that thinness was the “bonus of cancer,” and found herself looking in the mirror and admiring her deep and hollow collarbone.
Ms. Emmets, now 39, filled her closet with extra-small size clothes. At night she pressed her fingers against
her protruding bones, saying to herself, “I’m finally skinny.”
But it was only when her cancer treatment changed that it became clear that the body-image issues she had
been grappling with since her early 20s — when she would eat next to nothing and walk for six hours a day to deal with stress — had begun to resurface. When the new treatment didn’t make her sick, her appetite returned, and she began to gain weight. But instead of celebrating this sign of improving health, Ms. Emmets says she missed her size 2 jeans and was appalled by her round belly and full breasts. Her husband watched with concern as her body appeared stronger but she began imposing her own food restrictions and started shrinking again.
“During your cancer treatment, you have no control over your body — you give up your body to your
doctor,” said Ms. Emmets, who wrote about her experiences on the website The Manifest-Station. “You are
willing to do it because you want to live. Food restriction is the one thing that you can do to have some sense of control when everything is chaotic.”


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