‘Simply asking someone to eat more is not going to help and could make the situation a whole lot worse’ – James Knott on his battle with anorexia

SHP recently spoke to Health and Safety Manager at SJ Eastern, and SHP Rising Star in Construction finalist for 2021, James Knott, about his experience battling Anorexia Nervosa. We discuss James’ journey to recovery, what support was offered to him, and ultimately, what employers can do to best support employees battling a life-threatening mental illness.

James Knott, Health and Safety Manager

Around 1.25 million people in the UK have an eating disorder. Around 25% of those affected are male.

Among that 25% was Health and Safety Manager, James Knott.

In August 2015, James was diagnosed with Anorexia Nervosa, an eating disorder that most commonly causes sufferers to restrict food intake in order to keep their weight as low as possible, something James had been battling for multiple years prior to his diagnosis. In 2021, James was selected as guest editor for MIND’s August newsletter, and, within that, described receiving his initial diagnosis as having “lost all sense of control”.

“I was told I could no longer drive, go to work, and be physically active and play football. I remember the doctor saying to me, I have the power to section you under the Mental Health Act! Luckily that never happened”.

Speaking to SHP about his employer’s response to his diagnosis, James says: “I declared my diagnosis to my line manager after being signed off work. I was so fearful to tell them the news. When I did, I broke down and felt I had lost, I had defeated the illness that kept me going and focused for such a long time.

“My employer knew something was not right with me during my employment, but they didn’t know how to approach the subject. Once I did tell them about my diagnosis, they referred me to an external occupational health service through the business and made me aware of the company’s Employee Assistance Programme (EAP).

Now that the Mental Health First Aid England (MHFA) course is being introduced within workplaces, employers can gain an insight into signs to look out for of disordered eating amongst workers.”

James was assessed for his condition, and due to his low BMI (Body Mass Index), was offered 30 sessions of CBT (Cognitive Behavioural Therapy), which he attended on a weekly basis.

“I suppose, at the time of my illness, I would have said that thirty sessions of CBT was not enough, but now reflecting, it was just right.

“For the first few sessions I was in denial. I felt like I didn’t want to be there. When you are so low and down, you constantly feel like everyone is against you. But really, they’re not, they just want to help you.

“I was fortunate enough that my employer allowed me to attend those sessions while conducting my fulltime job. My line manager was extremely supportive, so much so that my dad even met my manager at the time I was ill.

“Towards the end of my therapy, I was offered ‘Arts on Prescription’, at first, I thought, why would I want to attend this? But I found the weekly sessions very therapeutic, creative, and relaxing. Everyone in the group was there for a reason. Some were even suffering from more chronic and irreversible illnesses such as cancer, it made me realise how far I had come, knowing that an eating disorder can be cured if you are willing to put the work in!”

Due to the stigma related to anorexia, often falsely viewed as a ‘mild disorder’, male sufferers are significantly less likely to seek help. Per 100,000 Anorexia Nervosa diagnosis’ 19 of those are related to males, though the number of those suffering is thought to be much higher in reality.

When asked if he believes his diagnosis was treated differently because of his gender, James says: “Absolutely, men have an increased risk of dying because they are diagnosed much later than women. This could be in part because of the misconception that men do not experience eating disorders, but they do.”

Writing for MIND, James says: “I’m a bloke, right? we don’t have feelings – this is very far from the truth. Especially when men come across as strong and macho.”

When James eventually returned to his fulltime position, he recalls the anxiety he felt at the prospect of having to prove himself a worthy employee once again.

“It felt like my first day in a new job. I was slowly phased back into work, starting with a couple of days, working up to three and then five. This phased return worked out to be just over a month. I was itching to get back to work and have some kind of normality in my life.”

James concludes by offering these three pieces of advice to employers on approaching the topic of eating disorders in the workplace:

Look for the warning signs – Typically when we think of someone who has an eating disorder, we think of people who are anorexic or bulimic and who look under weight, but this is far from the truth. It can be difficult to identify that an employee has developed an eating disorder purely on their weight. Warning signs to look out for include:
- Dramatic weight loss or weight gain
- Lying about eating
- Consuming lots of food very quickly
- Going to the toilet a lot after eating
- Exercising too much, in all weather conditions and at strange times of the day
- Avoiding eating with others
- Cutting food into small pieces or eating very slowly
- Wearing loose or baggy clothes to hide their weight loss.

Look for changes in behaviour – Anyone can have an eating disorder regardless of age, shape, ethnicity, and gender. Look for these changes in behaviours if you suspect someone has an eating disorder within the workplace.
- They are spending a lot of time worrying about their weight and body shape
- They purposely avoid socialising when they think food and drink will be involved
- They eat little food and eat in secret
- They make themselves sick or even take laxatives after they eat
- They exercise too much, like going to the gym each day after work
- They have extremely strict habits or routines around food and what they can and will not eat
- A change in mood such as being withdrawn, anxious or depressed. Not concentrating, thinking clearly, and losing focus while at work.

Approach with caution – Do not be a bull in a China shop, simply asking someone to eat more is not going to help and could make the situation a whole lot worse. Someone with an eating disorder does not want attention or conflict. So, approach with caution.

Want to know more about James’ story? Click here.

For more information on how to best support someone battling an eating disorder, click here.