Paying Off Emotional Debt

Justine Arreche saltinejustine Travis CI

Hey, I’m Justine. I’m a UX/UI designer at Travis CI.

I’m bulimic.

This session will be covering:• What exactly is an eating disorder?

• My personal struggle with eating disorders and how they’ve affected my life and career in tech.

• How your company can approach and help an employee potentially suffering from an eating disorder.

What is an eating disorder?

An eating disorder is an unhealthy relationship with food and weight that interferes with many areas of a person’s life.

One’s thoughts become preoccupied with food, weight or exercise.

A person who struggles with an eating disorder can have unrealistic self-critical thoughts about body image, and his or her eating habits may begin to disrupt normal body functions and affect daily activities.

(source: ANAD National Association of Anorexia Nervosa and Associated Disorders)

Eating disorders are more than about wanting to be “skinny”.

Coping mechanisms Sense of control Symptoms of other underlying issues

Anorexia Nervosa

A person with anorexia may have an intense fear of gaining weight or becoming fat. Someone with anorexia may practice unhealthy behaviors such as: restricting calories, only eating specific foods or skipping meals frequently.

(source: ANAD National Association of Anorexia Nervosa and Associated Disorders)

Bulimia Nervosa

A person with bulimia may also be intensely afraid of becoming fat or gaining weight. Someone with bulimia may eat large amounts of food in a short period of time (binge) and then eliminate the food and calories (purge). One may induce vomiting, exercise excessively, or use laxatives, diuretics, or diet pills to purge weight or calories.

(source: ANAD National Association of Anorexia Nervosa and Associated Disorders)

Binge Eating Disorder

This disorder involves eating very large amounts of food rapidly (to the point of feeling sick or uncomfortable). These episodes of bingeing occur frequently. When binge eating, a person feels like they cannot stop eating or control what or how much is eaten.

(source: ANAD National Association of Anorexia Nervosa and Associated Disorders)

Eating Disorder not otherwise specified (EDNOS)

EDNOS is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.

(source: ANAD National Association of Anorexia Nervosa and Associated Disorders)

Facts about eating disorders in the United States

20 million women 10 million men suffer from a clinically significant eating disorder at some time in their life.

1 in 10 people with eating disorders receive treatment.

(source: Characteristics and Treatment of Patients with Chronic Eating Disorders, by Dr. Greta

Noordenbox, International Journal of Eating Disorders, Volume 10)

Eating disorders are not limited to age, race or gender.

Anyone can develop an eating disorder at any time,

though they are more commonly developed at a young age.

An estimated 10-15% of people with anorexia or bulimia are male.

Among gay men, nearly 14% appear to suffer from bulimia and over 20% appear to be anorexic.

Men are less likely to seek treatment because of the perception that eating disorders are “women’s diseases”

Almost 50% of people with eating disorders meet the criteria for depression

Mental health issues related to ED’s:• Depression

• Alcoholism

• Drug abuse

• Obsessive compulsive disorder

Why is an eating disorder so serious?

The mortality rate associated with anorexia is 12 times higher than the death rate associated with all other causes of death for females ages 15-24 yrs.

Eating disorders have the highest mortality rate of any mental illness

Rough estimated mortality rates per eating disorder category

4% Anorexia

3.9% Bulimia

5.2% EDNOS

Effects eating disorders take on the body

Anorexia

• Monthly menstruation stops• Breathing, pulse and blood pressure rates drop

• Anemia• Loss of bone mineral density• Irregular heart rhythms/ heart failure

Bulimia

• Monthly menstruation stops• Mild anemia• Extreme heartburn• Electrolyte imbalance that can lead to cardiac arrest

• Ruptured stomach• Erosion of teeth enamel• Kidney and Liver damage• Internal bleeding• Gallbladder eruption

But there is treatment• Individual psychotherapy

• Group therapy

• Medication (to relieve paralyzing depression and anxiety)

• Nutritional counseling

• Hospitalization (for weight gain, suicide watch or stabilization of healthy eating habits)

Now, this is my story.

At 19 I was diagnosed and treated by the Cleveland Clinic for bulimia.

At 20, I had my first relapse.

At 25 I was sexually assaulted and began my 2 year relapse.

At first I just stopped eating.

I was so far into my depression that I felt nothing but saddness and disappointment.

I hid my bulimia from everyone. Eating was really the only thing I could do to be happy for even 5 minutes.

Excessive anxiety steered me into heavy drinking.

The amount of emotional debt I had acquired had almost left me paralized

My inability to preform my role at the company and my poor behavior cost me my job.

Then I moved to Germany, cutting all ties from Ohio and anyone who knew me.

But it was just the same thing only in a city where it was even easier to get away with my secret.

This past November I made a 911 call after I had collapsed and couldn’t breathe.

Recovery has been extremely difficult but I didn’t want to die.

How can you help someone you know or suspect is struggling with an eating disorder?

DISCLAIMER: This is not legal advice. I am not a lawyer and you should always seek legal council and get in touch with your human resources department before speaking with an employee on this topic.

Avoid making assumptions.

Rapid weight gain or loss doesn’t necessarily mean that person has an eating disorder.

People who are suffering from eating disorders can often preform their job duties normally on a day to day basis.

But some cannot.

An eating disorder can severely alter a person’s behavior and mentality making it difficult for them focus on job tasks.

This will ultimately interfere with the productivity of that individual, your team and your projects.

Team members talking about an individual behind their backs will ultimately harm team morale.

It is never appropriate to discuss another person’shealth issues in the office.

If you have concerns with the health of an employee or teammate, address your concerns with HR or senior management.

How will you know?• The employee will outright tell you

• Outward Symptoms

• Colleagues become concerned and inform management

Legal issues to keep in mind

Anytime a manager or team leader knows about confidential health information it puts the company at risk of future accusations of discrimination or unfair termination due to the person’s health concerns.

Additionally if something unfortunate should occur as a direct result of that person’s illness and no action was taken, the manager or employer could be accused of negligence.

This doesn’t mean be afraid to get involved

How to approach someone with an eating disorder

If your company does not have an HR representative this meeting should be with the most senior manager

Address work deficiencies such as forgetfulness, errors, and performance.

Address observations We suspect you’re anorexic because you’re way too skinny

You appear to have lost a significant amount of weight recently. Are you doing okay?

Follow up your concerns with helpful resources and options. Remind them of the health benefits your company’s health plan offers.

Provide information about the Family and Medical Leave Act (FMLA) if they would like to enter treatment.

Be clear that you want to support them and want them to be in great health.

Honor professional boundaries.

Remember that you are not a counselor

Instead of counseling, try researching eating disorder treatment in the area

Acquaint yourself with company health benefits.

What kind of medical and mental health benefits do you provide?

If the person has explicitly denied the presence of an eating disorder, simply say you wish to help them seek a physician or clinic to help them with their health concerns.

Remind your employee that accessing these benefits is completely confidential.

Once a team member has disclosed having and eating disorder, The Americans with Disabilities Act protects that person from discrimination based on the disease.

ADA law also requtires employers to make accommodations for people with disabilities.

Such accommodations include:• Flexible leave time for doctor’s appointments

• Flexible scheduling to accommodate for medication

• Make job performance expectations clear and meet regularly with a supervisor or manager for feedback

ADA law also allows for individuals to take up to 90 days off work to seek treatment.

These 90 days do not need to be consecutive.

What should you as a company do to ensure the mental health of all your employees?

Make mental health of all your employees a priority and a promise.

Thank You Justine Arreche saltinejustine Travis CI