Jay Walker is a Registered Psychotherapist (Qualifying) with the College of Registered Psychotherapists of Ontario. Jay completed a Master of Counselling Psychology through Athabasca University, where his research focused on areas of gender identity, body image, exercise, and eating disorders. Within his advocacy work, Jay writes and speaks publicly about these issues, including frequent collaborations with Sheena’s Place, a Toronto non-profit that offers free support groups to those living with eating disorders. I sat down with Jay to discuss his personal experience with disordered eating and excessive exercise, as well as the broad similarities and differences between men and women with eating disorders.
To begin, I want to understand your relationship with food and exercise growing up and how that changed when you entered university?
At a very young age, it was pretty normal—I ate with my family. Throughout high school, I became more aware of my body image the first time that I put on weight. No pressure from family, just the false knowledge that eating less was going to make my body change. I started chronically yo-yo dieting without really understanding what I was doing. In university, I got into athletics, which at first felt like a release from needing to be stressed out about food. Then it just compounded into exercise addiction with extreme food restriction that ultimately turned into cycles of restriction and bulimia.
Was there a specific moment where you recognized that this was a problem?
After university, I went to college for health and fitness, and it was in the second year where I couldn’t hide that I was sick anymore. There was a critical moment in front of everyone, where I was spiralling out of control in terms of being able to function. That was the catalyst for me thinking, “I cannot convince myself that anything that I am doing is healthy anymore.”
What did the journey to recovery look like for you?
It started with admitting that I had a problem and then being open about that with a few close friends and family. I reached out to Sheena’s Place because that was the only place I really knew, and I started attending some groups that were more specific to the behaviours I struggled with. Eventually, I also started doing one-on-one therapy because it is not actually about food, exercise, or your body. These represent coping mechanisms for other issues you may be dealing with.
How do you know when exercise is an addiction? How do you know when it is contributing negatively versus positively to your wellbeing?
A lot of people use exercise and movement to cope, and that is fine. When it is your only coping strategy, that is when it becomes a problem.
One of the groups that I run at Sheena’s Place is called “Examining Exercise and Movement.” We discuss different indicators for folks to question their habits around exercise: Are you working out when you are ill? Are you working out when you are injured while knowing that you should not be working out that part of your body?
Some of those are arguably more black-and-white, whereas others are grey. What happens when something gets in the way of your exercise routine? Is it the sort of thing where you’re like, “That’s frustrating, but it’s okay if I miss a workout.” Or is it a situation that spirals into anxiety? Do you directly compensate for missing that exercise through food restriction or modification?
In my opinion, if exercise is your only way of coping with anxiety, you can try to modify those behaviours, but ultimately you have to develop other skills to manage those anxieties or other difficult feelings.
There is a misconception that eating disorders only affect women. The stereotypical image is of a skinny, white, affluent girl, but some reports suggest that up to 25% of eating disorders cases occur in men. Concerns have been raised that men are underrepresented, underdiagnosed, and undertreated. Why do you think that is?
I completely agree that disordered eating can affect anyone regardless of gender identity, sex, or ethnicity. There are a few reasons for the underrepresentation in male-identified people. One is that men in North American culture are not socialized to talk about difficulties or feelings. Also, behaviours such as compulsive exercise or using restriction to create leanness are not just normalised, they’re often praised.
In the case of bodybuilders, who may not be restricting calories but are restricting in other ways, we do see a lot of the same difficulties. Anxiety is created when a workout is missed, and the social isolation of having to engage in extreme behaviours can have mental and emotional effects on people. Weightlifting all day long or needing every meal to be pre-planned and coordinated can isolate individuals from being able to go out and have a good time with their friends over a meal.
I have worked with a lot of men who did not recognize that their beliefs around food, exercise, and body image were keeping them isolated, which contributed to their mental and emotional distress. The symptoms can look different, but the motivations and implications are often similar.
Would you agree that the basic psychology of an eating disorder is the same regardless of your gender identity, in that it serves as a coping mechanism to deal with other stressors in life?
I agree, however, the underlying cause of any eating disorder can be very complex, including genetic and psychosocial factors. I will say that, in my work, I have never met a patient who suffered from disordered eating problems who did not also suffer from anxiety, depression, or trauma symptoms. The two go hand-in-hand.
To close, I know that you work with some great organizations that offer resources and support for those dealing with eating disorders. Can you talk about community options for those seeking help?
Sheena’s Place is the place to go in Toronto. Over the years, they have diversified the types of groups they offer. They are much more inclusionary, which is great because people of all identifications and all walks of life struggle with eating disorders. If you are someone who doesn’t have access financially, they do everything they can to break down barriers to mental health support. The National Eating Disorder Information Centre (NEDIC) is also a good way to gain more information, resources, and referrals. Through Sheena’s Place and NEDIC, you can be connected to therapists all over the city, some of whom specialize in eating disorders.
Is there anything you would like to say to end the interview?
The one thing that I hear from a lot of people is that they often wait until they are really ill to seek support. If you think you might be struggling, then it’s important to check in with yourself, check in with the people around you, and consult someone before it becomes critical. For a lot of people, circumstances get worse before they get better, so being able to recognize that and address it can be a way of saving yourself from distress.
I believe that a core part of the work is becoming attuned with the body. For a variety of reasons, such as trauma and an extensive list of other sociocultural factors, many of us are not given the opportunities to actually grow and become attuned with our bodies, its needs, and its natural responses to things. We are often told by outside sources what type of relationship we should have with our bodies, and all too often, those messages are completely the opposite of what our bodies need on a moment to moment level. I believe that becoming more aware of that relationship is one of the keys to recovery.
Edited by Negin Rezaie & Jeffrey Lynham