Turning Pain into Passion:

Eating Disorder Care in Rural Communities

Read more about Laura Shaw at the end of the blog.

Growing up in a small town in Ontario, Canada, with a population of just 6,500, I always found joy in the simple things. Life on Georgian Bay offered endless opportunities for exploration and adventure. It made trips to “the city”  thrilling, a chance to shop or go to the movies while dwelling in the hustle and bustle of city life. I grew up with my twin sister, and we were the youngest of four siblings in a close-knit family. My twin and I loved sports, and I found my passion in cross-country running and skiing during high school. These activities gave me a sense of identity and purpose, but beneath the surface, I struggled with undiagnosed anxiety, depression, low self-esteem, disordered eating, and a negative body image.

When I went to university, life took a challenging turn. Although I attended the same university as my twin sister and a few high school friends, adjusting to a larger city and losing my team identity proved overwhelming. I started to restrict food and exercise excessively as a way to cope with the stress and uncertainty. Despite the façade of being a happy, successful student, I grappled with an undiagnosed eating disorder, which became a means to control my life amidst the chaos. Still, I felt like I was walking a thin line, always trying to hide my behaviors from those closest to me.

After two years at university, I reached a breaking point and finally confided in my family about my need for help. Fortunately, there was a treatment facility in the city where I went to school, but my BMI didn’t meet the threshold for admission. This setback only fueled the eating disorder’s voice in my head, reinforcing the belief that I wasn’t “sick enough.” Thankfully, my family advocated for me, leading to my admission into a program in the US. This opportunity saved my life. It is a privilege to have the means to access treatment, a recourse many people in rural areas don’t have. 

After completing seven weeks of residential treatment, I felt more equipped to continue my education. But transitioning from a high level of care back to the demands of university life wasn’t easy. Although I had a supportive therapist on campus, the daily stressors of university, combined with the loss of my support system when my sister and friends graduated, made it difficult to maintain recovery. When I relapsed in the fall of 2014, my eating disorder spiraled rapidly, leading to a sharp decline in my mental and physical health.

Despite the need for additional treatment, finding help wasn’t straightforward. The closest program was a 2-3 hour drive away, and I was placed on a waitlist for over six months for outpatient care. My obstacles highlighted the broader issue of mental health resource scarcity in rural communities. Without local resources, I was forced to rely on my family and friends for support, renting a room 45 minutes away from the treatment facility (and 3-4 hours away from my family) and using a borrowed car to attend the program. The distance and logistical challenges added stress to an already difficult journey.

After completing 11 weeks of treatment, I returned to university and ultimately finished my degree. This challenging journey sparked my passion for becoming an Eating Disorder Recovery and Body Image Coach. Reflecting on my journey through recovery, I realize how invaluable meal support and coaching would have been in my darkest moments. The constant struggle with food and body image felt isolating. Having a coach who understood the intricacies of eating disorders and could provide support during meals might have made a difference. The reassurance and support during those difficult times would have helped ease the anxiety that often accompanies navigating recovery. The consistent encouragement and accountability that coaching provides might have reduced the burden I felt, making the recovery process less daunting and more manageable.

Now, as a recovery coach, I can offer the guidance and collaborative care I desperately wished for when transitioning from higher levels of care to everyday life. It’s a way for me to give back, knowing how critical it is to have support during those fragile moments in recovery. Yet, even with dedicated coaching, the broader challenges of accessing care in rural areas persisted.

The COVID-19 pandemic, however, shifted the landscape of healthcare, introducing new possibilities for reaching those in rural communities. Virtual treatment allows people to access care from the comfort of their homes, removing significant barriers like transportation and accommodation. The pandemic prompted many health services to adapt, and now, several organizations in Ontario offer free group programs virtually, increasing accessibility and support for those in rural areas.

Today, as a recovery coach, I find fulfillment in helping others navigate their recovery journey. It’s rewarding to provide resources to people in my hometown and beyond, knowing they don’t have to face the same hurdles I did. The transition to virtual care has made it possible to bridge the gap in mental health resources, allowing individuals to recover within their community and with the support of their loved ones. It’s a powerful step toward making eating disorder treatment more accessible, no matter where you live.

Learn about Laura Shaw