From Romania to the UK: a journey from Eastern to Western dietetics

The understanding of eating disorders in Romania was limited, and there was a prevailing belief that they were not recognised as real illnesses. In fact, so much so, they were often regarded as a myth!. This perception was influenced by the historical context of food scarcity during the communist era. The lack of recognition and understanding of eating disorders created barriers for individuals seeking help and deterred dietitians from specialising in this area.

To understand the challenges I faced transitioning into the role of a Registered Dietitian in the UK, it is important to examine the historical context in Romania. Romania was a communist country until 1989, when the Communist regime fell, bringing significant changes to the nation. The relationship between food and communism in Romania was not a positive one, as scarcity and rationing were prevalent. This historical context shaped the beliefs and understanding of nutrition and health in the country.

Under the rule of Nicolae Ceaușescu, Romania experienced a highly centralised command economy, which aimed to erase inequalities by directing resources towards industrialisation and national development. This approach resulted in severe food shortages and rationing, as resources were redirected to other sectors or exports.

The scarcity of essential food items, such as meat, dairy products, vegetables and even basic bakery items was a notorious aspect of everyday life in communist Romania. Necessities were not easily accessible or affordable for most citizens, resulting in long queues, black markets, and a constant struggle to obtain adequate nutrition. Rationing cards became a common feature, distributing limited supplies to citizens regardless of their preferences or nutritional needs. The communist regime heavily relied on propaganda to maintain control and shape public opinion. In the context of food, this propaganda often depicted scarcity as a consequence of external enemies or imperialist exploitation.

Additionally, the scarcity of food and poor nutritional practices during this period contributed to a rise in health issues such as malnutrition, anaemia and vitamin deficiencies with pellagra being widespread.

In 1984, a new and lower food standard was adopted. Romanians were entitled to 39 kilograms of meat, 78 litres of milk and 166 kilograms of vegetables annually. Oil and sugar were given once a month, the ration being one kilogram. They were entitled to half a loaf of bread per day and the chicken of a size of a pigeon was a dream most of the time.

The lack of education and access to proper nutrition further perpetuated these problems. The communist regime's control over information also hindered the dissemination of accurate knowledge regarding nutrition and health.

Post-communist countries faced challenges in adapting their healthcare systems to new political and economic realities. Limited funding and inadequate infrastructure have hindered the development and implementation of comprehensive mental health services, including eating disorder treatment programs.

Mental health issues, including eating disorders, have historically been stigmatised in post-communist countries. This stigma arises from a lack of awareness, cultural taboos and an underestimation of the severity of these disorders. Consequently, it was near impossible to get help for eating disorders as these were mostly perceived as caprice or a sign of weakness or personal failure.

The communist era led to a lack of nutritional education, as concepts related to health and nutrition were often overshadowed by the struggle for access to basic food. Although initially intending to reduce inequalities, the emphasis on resource management resulted in widespread malnutrition and health-related issues. Consequently, the population's understanding of the relationship between food and health was limited and often focused on immediate survival rather than long-term well-being.