Eating disorders, stress, and the executive role
While there are numerous studies on the mental health and well-being of employees, including the prevalence of eating disorders, the research on executives is somewhat limited. This could be connected to a number of factors, including misunderstandings about the overall work conditions and access to resources available to managers and executives.
Leadership roles indeed carry a number of benefits, but they can also be uniquely challenging. Research has found that:3,4,6,7,8
- 51.3% of executives report high stress levels, and 64.4% say that their primary stressor is related to their work
- Anywhere from 34.8% to 40.5% of company managers (depending on the industry) sleep six hours per night or less
- Stressed-out CEOs age more quickly and die earlier, with industry-wide recessions decreasing their average life expectancy by 1.5 years
- Compared to employees, managers face higher demands, experience more workplace conflicts, and receive less social support from peers
- Women in leadership positions experience even more pressure than men. In addition to reporting subtle forms of discrimination in the workplace, women are more likely to take on more family and household responsibilities.
All told, these factors may make executives more susceptible to developing eating disorders. A growing body of research indicates a strong association between chronic stress and the onset of such conditions.9
Further, technology has blurred the lines between “end of work day” and “time off,” creating a work-life balance that can be even more challenging and hampering attempts at self-care.
Self-oriented perfectionism, or holding oneself to unrealistically high expectations, is another strong risk factor for developing an eating disorder, and these traits have also been found among workplace managers.10,11
It’s also relatively common to skip lunch or snacks at work when your workload is high, but this is not healthy and can be a means of disguising restriction as a necessary behavior to get work done. It could also initially be done relatively harmlessly and progress to disordered eating or an eating disorder.
Executives with eating disorders: Signs and symptoms
Just like anyone else who struggles with an eating disorder, executives and managers may be in denial of the problem or work to actively hide their symptoms. This can be dangerous, as it allows the issue to persist longer, potentially leading to more psychological, physiological, and emotional damage.
If you suspect you or a loved one are struggling with an eating disorder, it’s important to seek out help as soon as possible. Early detection and intervention have led to improved prognosis and lower risk for premature death and other serious consequences of disordered eating.1
Only a medical professional can make an official eating disorder diagnosis. But if you notice these signs in yourself or a loved one, it could indicate a deeper problem.2,5,12,13,15,17
Preoccupation with food
- Cutting food into small pieces or other behaviors with food that avoid the intake of calories or subtypes of food
- Excessive interest in “healthy” eating to the detriment of being able to enjoy meal experiences without extensive involvement in food selection
- Refusal to eat certain food types like fats or carbs
- Restrictive eating patterns or only eating in tiny portions
- Conversations revolving around food, dieting, or counting calories
- Spending an excessive amount of time on lunchtime meals
- Avoiding meal times and other work events where food may be present
- Fertility issues
- Preoccupation with exercise
Preoccupation with one’s appearance
- Excessive interest in dieting, weight loss, and exercise
- Preoccupation with exercise under the guise of “health,” but to the detriment of physical health and/or social connections
- Comments degrading or harshly judging one’s own body
Behavioral changes
- Eating alone or avoidance of social engagement while eating
- Patterns of behavior that result in not eating
- Excessive caffeine consumption in lieu of nutrition
- Skipping meals or having a chaotic eating schedule
- Abnormal decrease or increase in productivity levels
- Scheduling meetings or work events around workout sessions
Mood and cognitive changes
-
Difficulties concentrating
- Poorer decision-making ability
- Uncharacteristic irritability
- Withdrawal from coworkers, social events, and usual activities
- Other signs of struggling, including missing appointments and/or missing work
Physical changes
-
Bloating
- Frequently feeling cold
- Frequent weight fluctuations
- Excessive or sudden weight loss or gain (note, this does not imply you must be underweight)
- Dry or thinning hair or hair loss
- Constipation or stomach pain
Treating executives with eating disorders
Eating disorder treatment programs for executives vary depending on the condition and the patient’s needs. Possible options include:13,14
- Nutrition education
- Psychotherapy
- Medications
- Hospitalization
- Partial hospitalization and intensive outpatient treatment
- Residential treatment
Nutrition education
A registered dietitian can help executives with eating disorders improve their eating habits, create grocery shopping lists, prepare nutritious meals, and, most importantly, help heal the person’s relationship with food.
Psychotherapy
Many executives with eating disorders benefit from cognitive behavioral therapy (CBT), group therapies, and a wide range of therapeutic modalities that focus on body image, self-esteem, emotion regulation, mindfulness, acceptance and commitment therapy (ACT), and movement groups. The many types of psychotherapy can help them understand and heal from the intrusive eating disorder thoughts, understand the origins of their thoughts and behaviors, and develop new ways of managing those thoughts and impulses. Forming connections with others can be a powerful mechanism to help create the pathway to “deliver” new messages and ways of adaptation for those who suffer from eating disorders.
Medications
While some medications, like antidepressants, cannot necessarily cure eating disorders, they may help alleviate co-occurring conditions like anxiety, depression, mood disturbances, and other aspects of the patient's mental health. This can be done while improving the patient’s thoughts about themselves, improving social and family connections, and how to nourish themselves more joyfully.
Hospitalization
In some cases, hospitalization may be necessary for executives with more severe physical or mental health problems.
Partial hospitalization and intensive outpatient
Executives struggling with an eating disorder can benefit from the intensiveness of inpatient care without the inflexibility or rigid schedule often associated with inpatient programs. At Within Health, our virtual treatment program provides this level of care from the comfort and privacy of their home. We adjust to their busy schedules to deliver them eating disorder treatment that is individualized and tailored to meet their needs.
Residential treatment
A residential program where the patient temporarily relocates to a live-in facility may be necessary for patients who need longer-term treatment or have been treated either in an outpatient, intensive outpatient (IOP), or partial hospitalization program (PHP) setting without sufficient improvement or within a hospital setting and need a step down into a 24-hour care environment.
We offer IOP+ and PHP+ programs for executives.
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Executives with eating disorders: How to help
People in leadership positions may have better access to treatment than those with lower socioeconomic status. However, due to the pressure and high demand of their jobs, some executives may prioritize their work and career over their physical and mental well-being.
Just as anyone struggling with an eating disorder, executives or managers may find it hard to admit or even acknowledge that they have a problem. But there are some ways to support these people—or anyone—who is struggling with an eating disorder.16
Lead with compassion
It is recommended that friends, family members, and coworkers looking to help someone with an eating disorder avoid stigmatizing language and show that they are coming from a place of genuine care. It is also a good idea to offer to listen, help them get in touch with a professional, or refer them to a helpline.
Tell someone who knows them better
An executive's coworkers may notice the signs of an eating disorder but may not be comfortable broaching the subject. Employees may be worried about jeopardizing their jobs or feel it is not their place to discuss sensitive personal issues with their CEO or manager. In such cases, it may be best to approach someone who knows them better.
Be prepared for negative reactions
When challenged, some people with an eating disorder may become angry, hostile, or dismissive. While such responses are expected, such reactions can make others uncomfortable, especially if they work for that person or are lower in the organizational hierarchy.
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