Wednesday, December 3rd, is the UN International Day of Persons with Disabilities, a day that seeks to promote understanding, support, and awareness of disabilities and the impact that they can have on the lives of individuals. This year one of the main themes is: “including persons with invisible disabilities in society and development.” Invisible disabilities include mental illnesses like eating disorders.
It’s not common to consider an eating disorder a disability.
Yet the very definition of a disability would suggest otherwise. Under the UK Equality Act 2010, a person is considered to be disabled if they have “a physical or mental impairment which has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities.”
Let’s break it down.
Eating disorders inflict physical damage on the body by manipulating food intake and activity levels and ignoring the body’s needs, which stem from significant mental anguish, myopic obsession and painful distress. Not being able to fuel your body for the life you wish to lead, and inhibiting its ability to function in basic ways such as being able to have children, pump blood around your body or keep your bones strong would seem pretty substantial. An eating disorder is by definition long-term. It’s not just a diet.
And as the disease takes over, the fixation with food and body becomes all consuming, and you are literally unable to think about anything else, regardless of what anyone else may see, it has an adverse effect on your normal day-to-day activities. Every day activities like getting washed and dressed, preparing and eating food, carrying out household tasks, reading and writing, watching television, and taking part in social activities like having a conversation. These simple activities all too often fall by the wayside in the midst of an eating disorder.
Does a disability only counts when it is physically visible?
In the US the Social Security Administration considers eating disorders “potentially disabling” although this seems to be if the individual can prove damage to their skeletal system, heart failure, chronic anaemia or a digestive disorder. In this case it seems as though the disability only counts when it has a visible, or at least provable, physical effect—something that the UN day wants to challenge.
Part of the difficulty in seeing an eating disorder as a disability may come down to people’s attitudes towards and understanding of what an eating disorder is. There is generally a sense of sadness for people with disabilities, seeing it as an affliction that someone would be better without and has not chosen (and this condescending and prejudiced attitude has been challenged at length). There is still the view that eating disorders are somehow a choice. And that a person with a stronger disposition wouldn’t “get” and ED. A few medical studies have looked at the correlation between eating disorders and learning disabilities or intellectual disabilities; and body image and those with disabilities. Yet, few studies examine how eating disorders are disabilities.
A 2009 study stated, “eating disorders are associated with some of the highest levels of medical and social disability of any psychiatric disorder.” According to a case in the UK law court the disabling effects of Anorexia Nervosa can constitute physical disablement even if the root cause of the illness is “psychiatric”. Although a note for employers explains that it is not necessary to define an illness specifically as physical or mental, or to identify where it started. It’s the impact that’s important.
And therein lies the rub. It doesn’t matter whether someone else can see that you have an illness, or whether your difficulties tick all the right boxes. Giving an eating disorder a name does not make it any more or less of a hindrance on your life. There’s a lot of support in the disability field, which may mean that being “part” of this space can open up opportunities for practical or financial assistance with recovery. At the very least it can creates a space in which an individual feels acknowledged for their illness and more able to move forward.
At the end of the day, it’s a case semantics, and breaking it down. Is your eating disorder an enabler or disabler to living the life you want to lead?