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StopSO are a UK charity working with people at risk of sexual offending or who are concerned about their behaviour. It might be those who are being investigated for crimes, those who have been convicted, or people who have never been in trouble with the law but are concerned about their thoughts about children. StopSO also work with partners and family members of offenders, as the impact on the people around them can be traumatic, as well as with survivors of abuse.
I joined StopSO having been aware of their important work for many years, as I’m a strong advocate for perpetrator and offender work. This, I believe, is the real way to prevent and tackle abuse. I previously worked with domestic abuse perpetrators – you can read my experiences and reflections on this here. This post is for anybody interested in StopSO work; whether you’re looking for support for yourself or a loved one, if you’re a fellow therapist, or if you’re simply curious. I will share some of my reflections, but confidentiality is crucial, so I do not share any client details. Further resources and contacts are listed at the end.
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Weight Loss Injections, Eating Disorders and Disordered Eating - Counselling Tutor Podcast10/4/2025 I was pleased to be a guest on the Counselling Tutor podcast, talking to Rory Lees-Oakes about weight loss drugs and eating disorders/disordered eating. Weight Loss Drugs and Disordered Eating [starts at 25:38 mins - click here] Rory and I unpacked the increasing use of weight loss injections like Wegovy, Ozempic, and Mounjaro, and the connection to disordered eating and eating disorders. Discussion points include:
I emphasised the need for greater awareness of weight stigma and eating disorders in therapy, and highlighted the importance of informed therapeutic exploration when clients are using or considering weight loss injections. Further reading and resources Blog - why it can be hard to talk about weight loss injections (and why I'm doing it anyway) Blog - weight loss injections and food noise Blog - coming off weight loss injections Guest post - Dump the Scales (weight stigma and weight loss jabs) Podcast - GLP-1 Truth Serum by Virgie Tovar Training for therapists and professionals on weight loss injections - NEDDE Understanding Weight Loss Injections and Diet Culture, with Online Events and Counsellors' Staffroom - live training on 8th December 2025 Body image and disordered eating are complex issues, with psychological, biological, social and cultural influences. This blog explores eating and body image struggles – what these may entail, where they may stem from, and the impact of weight stigma and societal influences. It’s an introduction to the topics so further reading, learning and training are suggested at the end.
This blog was inspired by a chapter I wrote for a book called “A New Introduction to Counselling and Psychotherapy” by Mamood Ahmad. I was delighted to contribute this topic as it is often left out of counselling studies, yet body image and eating problems are so prevalent, it is crucially important. I've been writing and speaking about weight loss injections (GLP-1s such as Wegovy, Ozempic, Mounjaro) a lot recently, which I feel is important, but it doesn't always feel easy. I'm certainly not short of things to say on this topic, but it is an emotive one which people have a lot of opinions about, often conflicting.
When I hear others talk about the subject, they're often trying to approach it with understandable nuance and respect. It's important not to add to the judgment of people who choose to take weight loss injections. Comments online can be cruel, which sadly isn't a surprise, with people saying it's the easy way out or that it shows laziness. This is absolutely not the case. Many people struggle with low self-esteem and painful thoughts around food and their bodies. Eating distress goes far beyond what fits neatly into an eating disorder diagnosis, and far more people struggle than we realise. There’s a new Netflix documentary called Fit for TV: The Reality Behind The Biggest Loser. Of course, I had to watch it straight away! Calling out the harms of the infamously mean show The Biggest Loser? Count me in. Unfortunately, the documentary series didn’t quite go far enough. Yes, they named a lot of the harm, but they never once mentioned eating disorders, and they still had an overall weight loss message.
So let’s talk about what they left out… My therapeutic approach to working with eating distress and eating disorders online in the UK
Disordered eating is a broad term. It can include restriction, bingeing, emotional eating, obsessive and/or distressing thoughts about food or body image, compensatory exercise, and a whole lot more. Some people meet the criteria for a clinical eating disorder diagnosis, such as anorexia, bulimia or binge eating disorder, but many do not. Either way, therapy can be a helpful place to start untangling what’s going on beneath the surface. In my work as an eating disorder therapist online, I don’t diagnose - this is usually done by healthcare professionals or psychologists. As a therapist, I’m curious about your unique story and how you experience disordered eating. I work with a wide range of eating, body image and weight concerns, with or without a label or diagnosis. No problem is insignificant - you deserve help. Weight loss injections, sometimes known as GLP-1s or by their brand names such as Ozempic, Wegovy or Mounjaro, are big business right now. They’re available through the NHS with certain stipulations, but can also be bought online, through pharmacies, and a growing number of outlets (not all of which are safe or reliable). They don’t work for everyone, and at some point, people may need or want to stop taking weight loss injections. It’s worth thinking about that before starting them, if possible, in order to make an informed decision.
This blog explores what can happen when you come off GLP-1 weight loss drugs such as Wegovy and Mounjaro. It’s for anyone taking or considering taking them, as well as therapists and other professionals who work with clients encountering weight loss injections. I'm an eating disorder and body image therapist, so this blog is focused on the psychological impact of stopping GLP-1 weight loss injections. I would always recommend psychological support before, during, and after taking these drugs, where possible. Avoidant/Restrictive Food Intake Disorder (ARFID) is a lesser-known eating disorder. It can impact every part of life, from physical health to social interactions and self-esteem. In this blog, I’m sharing a bit about what ARFID is, my own lived experience, and some reflections from my practice as an eating disorder therapist.
Struggling with negative thoughts about your body? You’re not alone - there is support available.
I’m an Integrative therapist and I work online with a range of body image and eating problems. I’ve spent many years working in eating disorder services and learning about body image, partly due to my own lived experience in the past. I’m passionate about helping others tackle their body image concerns, so I work online offering body image therapy for anyone in the UK. This post will explain what body image therapy is, what it can involve, and how it can help you feel more at ease in your own skin. This is a personal piece about how I went from being someone with very low self-esteem and self-worth, to a counsellor specialising in body image and eating disorders. I hope it may help others who may want to train to be counsellors, or for those struggling with self-esteem and body image problems, or for anyone who might just be interested in reading the journey.
I grew up in the Midlands in the Eighties and Nineties, what I would think of now as working class but I never considered that back then. From as young as I can remember, I didn’t like myself very much. I hated my body, and I knew I had to try and make myself thin to be loveable. I was a very quiet, shy child who found it difficult to speak up. A lot of people were very mean to me, both other kids and adults. I didn’t think I was particularly good at anything and didn’t think I was worthy of love. As an Integrative counsellor based in the UK, I was keen to watch the BBC series, Change Your Mind, Change Your Life, hosted by Matt and Emma Willis. The show aims to shed light on the therapy process by following individuals through their therapeutic journeys. The series brings therapy into the public domain, but often it’s confusing for potential clients (and for those thinking of training to be counsellors/therapists) to understand different job titles, roles and modalities/approaches.
So, who are the therapists in Change Your Mind, Change Your Life? What’s the difference between a psychotherapist and a psychiatrist? What are all these different confusing modalities? And is Change Your Mind, Change Your Life a realistic portrayal of therapy? If you haven’t seen the show but are still interested in understanding more about therapeutic modalities and how to find a therapist/train to be a therapist, then do also keep reading! Let’s talk about Irvin Yalom’s “Fat Lady” chapter from Love’s Executioner. I was given this chapter to read as “homework” during my first year of counselling training. Well… I wasn’t expecting it to pack such a punch.
The way Yalom talked about his client, Betty, was shocking; “I have always been repelled by fat women. I find them disgusting.” His evocative words to describe her seemed purposely cruel, clearly chosen to make the reader uncomfortable. As a writer, I partly admired being able to evoke such strong reactions, and I’ll admit I read the whole thing captivated but astounded. I went back to my course the following week itching to talk about it, but there wasn’t space or time for discussion. So I bought it up in “open group” (like PD group) and shared my concerns about reading the “Fat Lady” chapter without any time for critical reflection. Most people said they were just blown away by Yalom’s honesty, and that was it. Back then I didn’t have the knowledge, language or confidence to challenge this further, but I certainly do now! For context, I work in private practice, predominantly with people with disordered eating and body image problems, and I work with many clients who have experienced weight stigma and anti-fat biases. I train counsellors on these topics and have read and written about this extensively. It’s safe to say this blog has been a long time in the making and I hope it’s a helpful deep dive. Following the recent Supreme Court ruling that “the legal definition of a woman is based on biological sex”, I want to show my support for people trans, non-binary and gender queer people. As a counsellor with a strong ethical stance in social justice, I’m keen to make it clear that I stand with the trans community (which I’m using as an umbrella term), particularly trans women at this difficult time. Trans people are loved and supported, this week and forever.
The term "incel" has become a focal point of media attention lately, since the release of Adolescence on Netflix, and due to violent incidents in recent years such as the Plymouth shooting in the UK, and the Toronto van attack in 2018. The term "incel" stands for “involuntary celibate”; a label adopted by people, predominantly men, who feel unable to form romantic or sexual relationships despite wanting to, and often blame others for this. What started as an online support group (ironically, set up by a queer woman) in the 1990s grew into an ideology rooted in anger, resentment, and misogyny.
Unpacking Adolescence (Netflix): A Therapist’s Reflection on Masculinity, Power Dynamics and Shame3/25/2025 Contains Adolescence spoilers and discussion of violence/abuse.
I also have a video covering this on YouTube if you prefer to watch/listen. Adolescence (Netflix) has sparked a lot of important conversations about social media, masculinity, the manosphere, and more. As someone who has long been concerned about the rise of misogyny and the manosphere, I’m glad this show exists. It’s also rare to see a show that focuses on the perpetrator’s family and the abuse and stigma they experience. I’ve always been fascinated by what leads people to cause harm. I’m a counsellor in private practice and I used to work for a domestic abuse charity with perpetrators doing group and 1:1 work with predominantly men (you can read more about my experiences here). In this blog, I’m doing a deep dive into Netflix drama “Adolescence”, exploring the influence of the manosphere, power dynamics, gender roles, shame and trauma. These are just my theories/opinions and may differ from others, and also keep in mind that counsellors and psychologists are trained very differently. Writing can be a powerful tool for exploring and processing emotions. As a writer and counsellor, I have experienced for myself how writing can be deeply therapeutic. We pour parts of ourselves into our words, even sometimes without realising it. Looking back, I can see that my early fiction writing was a way of processing my feelings and experiences, as well as my journalling. Writing blogs helped (and continues to help) explore themes like trauma, social inequalities, eating disorders, and body acceptance, which are central to my work.
Below are some suggested writing exercises that may help build self-compassion and improve body image. Some of these exercises are more structured than others, so do whichever ones feel right for you. The key is to write in a way that feels good or helpful, without any writing rules or pressures. People struggle with eating in many different ways, so there is no one-size-fits-all approach to recovery and healing. I'd like to offer some insights into what healing your relationship with food might look like, based on my experience as an eating disorder counsellor but also from my own lived experience. This is just my perspective and some common themes I’ve noticed in practice. The most important thing is that you find the right path to explore these issues in a way that feels right for you, at your own pace.
With all the buzz about weight loss injections recently, I’ve been hearing the term “food noise” a lot. As an eating disorder counsellor, I often work with people who experience some kind of food noise – incessant thoughts about food, cravings, anxieties about eating, food rules, and more. Many people discuss taking weight loss injections, such as Ozempic, Wegovy, and Mounjaro, to help reduce food noise. But is this the best approach to tackling food noise, and at what risk?
I appreciate that many people feel they need weight loss drugs desperately, and they have every right to take them. The problem is that many people don’t qualify for weight loss injections through the NHS and seek them elsewhere. This can lead to numerous problems and risks, which I discussed in a previous blog post. I stand against harmful diet culture and the idealisation of thinness in our society but I do not judge people who choose to take weight loss drugs or pursue other weight loss interventions, given the cultural pressures we face. As a counsellor, my main mission is to help people improve their relationships with food and their bodies and to build self-acceptance. As an eating disorder therapist, I hear a lot of people say they feel like they can’t stop eating. They say they’re out of control, that food has a hold on them, and they just can’t resist certain things (normally the food deemed "bad"). For many, it can feel like inner conflict, like an angel and a devil on their shoulders shouting at them.
Food can certainly feel like an addiction for many people, with powerful thoughts and feelings commanding them to eat. It can feel like a yearning need, with real distress at the thought of not getting what they want. This is not simply just about willpower or weakness, this is a distressing battle of the mind. It can have such a huge impact on daily life and mental health. This distress can be indicative of disordered eating or an eating disorder, for which people deserve tailored help/therapy. There can be similarities in how addictions and eating disorders develop and are maintained, but there are important differences when it comes to treatment/ therapy. It’s that time of year again - the endless barrage of adverts: diet products, gym memberships, expensive supplements, weight loss drugs and injectables and more. And let’s not forget the “psychological approaches” to weight loss - the ones that say “we’re-definitely-not-a-diet” when they most definitely are! The New Year comes loaded with expectations: to be better, fitter, healthier, more successful… and, of course, to BUY MORE STUFF. Businesses selling diet culture don’t care about your health, they care about making money.
So here’s your friendly reminder: you don’t have to listen to any rules, “shoulds” or “musts” about your body in the New Year. Sometimes, the stress of trying to “improve” does more harm than good. Perhaps the aim can just be to show ourselves a little more kindness and compassion this year. Did you know that many people with eating disorders are not underweight?
It's common for many people to think of thin young girls with anorexia when talking about eating disorders but realistically it's a lot broader, with disordered eating affecting people of all different shapes and sizes. One study reported that only 6% of adolescents with an eating disorder are classified as underweight. This is hugely important for the way we view, and help, people with eating disorders. It’s the reason why I’m so passionate about the connection between weight stigma and disordered eating, and about my therapeutic work with people experiencing eating distress and body image issues. So I wanted to talk about “Atypical Anorexia” in this blog as this is an aspect of disordered eating impacting people who are not underweight, and this is heavily influenced by weight stigma. Binge eating disorder (BED) is one of the most prevalent eating disorders, with many people caught in a difficult cycle of negative thoughts and difficult emotions. It can often be a secretive or shameful thing to talk about, so that’s why it’s important we do talk about it! Whether someone has a diagnosis or not, binge eating can have a huge impact on a person’s life. So let’s dive into what binge eating is, the binge cycle, and most importantly, what can help stop binge eating.
Skinny jabs. Weight loss injections. The new miracle drugs to “tackle the ob*sity crisis” once and for all. Drugs like Ozempic and Wegovy are being hailed as wonder drugs. Oprah raves about weight loss drugs and says “obesity is a disease” so it’s not about willpower. This apparently can help get rid of weight stigma…by reinforcing weight loss and thin ideals? This doesn’t make much sense to me.
A couple of years ago I wrote an initial reflection on working with perpetrators of domestic abuse when I was relatively new to the work. Since then, sadly the service has closed as the funding ended. This is not uncommon in this field; victim services are barely funded enough so perpetrator services can be a hard sell. So, given this sad ending, I wanted to reflect on this amazing work and what I’ve learned about working with perpetrators of domestic abuse, and about what we need to do as a society to help men. Due to the nature of this work, no names or identifying information about the organisation or individual involved will be used.
Body image problems affect lots of different people. We live in an appearance-centred society, but it’s not just about vanity or being shallow. Body image issues aren’t something “silly” experienced by teenage girls, nor are they something we can just “get over”. Body image is partly about how we see ourselves and perceive our bodies, but this is influenced by wider issues such as societal views, diet culture, inequalities, power dynamics and discrimination.
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AuthorMel Ciavucco |