Suppose you see or know or suspect that an employee has an eating disorder. What should you do? Here's a guest article by Joy Nollenberg, director of The Joy Project addressing this issue. She wants readers to know that legal issues abound in this realm and that her words are not legal advice. In other words, check out your legal position before embarking on a workplace confrontation.
There may be times when someone in the workplace appears to be very ill with an eating disorder. This can be a difficult situation with many potential pitfalls. It's important to keep these points in mind.
- Be sure that any action you take is appropriate.
- Ensure the quality of the work the potentially eating-disordered person is doing, while minimizing the risk of being held liable for any errors that the employee may cause.
- Make sure that the person knows that support may be available and that people are concerned for her or his welfare.
- Respect that person’s privacy, their right to keep their personal healthcare-related information to themselves, and their feeling of security with their coworkers.
I am an eating disorder advocate, but my 'day' job is in Human Resources. While I am not an attorney, and what I write here should never replace legal advice from a qualified professional, I can share some suggestions on where to begin in situations such as this.
First and Foremost: Avoid Making Assumptions
While sudden weight gain or loss may indeed be the result of an eating disorder, there are other situations that may cause fluctuations in weight or appearance. Additionally, it is entirely possible that the employee may already be seeking treatment—they just didn't want to tell their coworkers about it.
Perhaps the most dangerous assumption is that if the person appears unhealthy, they must be compromised mentally. While an eating disorder can wreak havoc on a person’s ability to think clearly (imagine how you feel at work when you've worked for two hours past your normal lunch time without eating, and letters are swimming together on the page you’re trying to read), many individuals with eating disorders still manage to function quite well, despite their illness.
Don’t Diagnose or Seek to Have the Individual Acknowledge or Accept a Label
Often, people approach people with eating disorders with the intention of getting the person to ‘admit’ that they have an eating disorder. I would not recommend initiating the conversation in this manner. Often, people resist labels, for many reasons.
There are many reasons why a person may not acknowledge their own eating disorder within the workplace. One of those reasons is that they may not acknowledge it to themselves yet. However, it is also entirely possible that her statements of "I do not have an eating disorder" may actually be the equivalent of "I refuse to acknowledge my eating disorder *to YOU*, at this time, in this situation."
At work, an employee may fear that having a serious illness will put their job at risk, so they may strongly deny it. However, many employees are unaware that there are some laws that offer some protection against termination for illness.
So, what happens when you work in an environment where having a mentally compromised employee could be a huge liability risk?
Be Aware of Legal Issues Related to Health Issues.
Most importantly- know when to seek assistance from someone who is more knowledgeable about dealing with the legal issues that may arise, and know who should be the one to address the issue at work. As an HR person, I cringe any time I hear that a person's peers are discussing their health status at work, amongst each other.
I would highly recommend that anyone who is concerned would head directly to Human Resources (do not pass GO, do not collect $200...), or some administrative representative with similar responsibility. If you hear other employees discussing the person’s health in the workplace, let them know that you appreciate their concern for their fellow coworkers, but ask them to respect the person’s right to privacy.
Remind them that if management addresses the situation with the employee, it is not appropriate to discuss the details with his/her coworkers without his/her consent.
Be Aware of Legal Issues Related to HIPAA
Any time a person’s manager knows what should be 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 did happen as a direct result of the person’s illness, and it is known that the manager had been aware of the person’s illness (but took no action), the manager could find themselves accused of negligence.
Team-wise, if the person is aware that people are discussing him/her while they are not around, this can greatly impact their morale and trust in their coworkers. So, how does someone have this difficult conversation with a potentially ill employee?
As I said before, forget labels. Whether or not their issue can be called an ‘eating disorder’ or ‘bulimia’ or ‘anorexia’ or whatever, it is essentially irrelevant at this point. What matters is their ability to perform their job and their awareness of any supportive resources that may be available to them.
Address Work Deficiencies, not the Name of an Illness
Surely, if someone’s health is sufficiently impaired so much that their entire judgment process is being questioned at work, there must be some smaller, more quantitative signs of her 'impaired judgment.' For example:
- Is she frequently forgetful?
- Does he miss details?
- Does she make frequent errors?
- Has he passed out on the job?
THESE are the types of things that I would suggest addressing directly. Before meeting with the employee, it may be helpful to document some of the errors you are concerned about. Have some concrete examples written down, and be prepared to discuss them.
Be Professional and Respectful
Ideally, the conversation should be led by someone from Human Resources. If this is not possible, then a senior manager can lead the conversation. Either way, be sure to have this meeting in private.
Set aside sufficient time to discuss your concerns and allow the person to respond. Avoid beginning the conversation with something along the lines of "We think you have an eating disorder and you're clearly impaired," as he/she is likely to get immediately defensive and refuse to engage in the conversation further.
Instead, address the concrete examples of impacted job performance and clear statements about what you’ve observed about their state of health. Again—do not make assumptions or judgments. It may be appropriate to say, “You appear to have lost a significant amount of weight in the past few months. I’m concerned, and want to make sure you’re doing ok.”
It is most likely not appropriate, however, to say, “Clearly, your diet is too extreme, and you should quit trying to look like a supermodel.”
Remind Employees of Available Helpful Resources
Follow up the "we're concerned about you" comments with "I would like to remind you which benefits and resources are available to you as an employee." You may want to provide them with information about their right to take a leave of absence under the Family and Medical Leave Act (FMLA), or your company’s short-term disability plan.
An employee may also have the right to request specific accommodations under the Americans with Disabilities Act (for example, restriction on the amount of time spent lifting heavy items each day or permission to take brief 5-minute breaks to eat if their blood sugar is low).
Be clear that you wish to support the employee in reclaiming their health and that you are open to additional conversations about how the company can best provide assistance while still maintaining the expectation that essential job tasks are completed appropriately.
Honor Professional Boundaries and Do not Step into a Counseling Role
Do not attempt to ‘counsel’ the employee on issues of nutrition or health. Rather, offer to assist them in finding eating-disorder-specific treatment in your area (or, if the person has specifically denied the presence of an ‘eating disorder’, you can simply say that you wish to help them find a physician or clinic that can assess their health concerns.) If your company offers an employee assistance program, you may wish to refer the employee to the program for further assistance in obtaining treatment.
In Summary, the most important considerations when confronting someone with a potential eating disorder at work are:
- Know your own limits, and seek assistance from professionals when appropriate
- Avoid assumptions or judgments. Stick to concrete examples and express concern in an empathetic and non-accusatory manner
- Protect an employee’s privacy in regards to their health concern as much as possible
- Let the employee know there are resources available, and offer to assist them in obtaining treatment if they would like your help
- Let them know you are concerned for their welfare, and that you want them to be healthy and able to perform at their best
The Joy Project
The Joy Project is a non-profit, grassroots organization based on the philosophy of using real-world, workable solutions to end the epidemic of eating disorders. We work towards reducing the rate and severity of eating disorders by supporting and conducting research, education, and support programs.
Thank you Joy. I receive letters and phone calls asking me about how to confront someone at work who has an eating disorder. This clarifies many issues. You show employers how to consider their position. You show co-workers the importance of addressing their concerns through appropriate channels. And, hopefully, you inform people who think they see an eating disorder and want to rush in with a plan in their head that may be detrimental to the other person, themselves and perhaps the company.
Let Me Know Your Thoughts. Comment on the questions in the Section Below.
- Readers, have you wanted to confront someone with an eating disorder at work?
- If you have an eating disorder, how would you respond if Joy's advice were applied to you in your workplace?
The opinions and views of guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Recovery, but an effort to offer discussion of various issues by different concerned individuals.
Reviewed by Joanna Poppink, MFT. Joanna is a psychotherapist in private practice specializing in eating disorder recovery, stress, PTSD, and adult development.
She is licensed in CA, AZ, OR, FL, and UT. Author of the Book: Healing Your Hungry Heart: Recovering from Your Eating Disorder
Appointments are virtual.
For a free telephone consultation, e-mail her at