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.
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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.
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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.

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.

I recently saw “Your Fat Friend”, a documentary about Aubrey Gordon made by Jeanie Finlay. I’m a big fan of Aubrey’s work, her books, blogs and podcast - Maintenance Phase. She’s been a huge influence on me both personally and professionally. I'm a counsellor and I work with people struggling with eating, body image and the impact of weight stigma. I’m passionate about highlighting the importance of helping those in larger bodies with eating disorders, and training other counsellors in understanding disordered eating and weight stigma. This film just lit even more of a fire in me.

Spoilers! Everything Now is a coming-of-age drama comedy on Netflix, with a protagonist in eating disorder recovery. If you haven’t seen it, maybe go and watch it and come back, or if you’re not fussed about spoilers or have no intention of watching it and want to keep reading, then crack on! I’m a counsellor and I work with people with eating disorders, disordered eating and body image problems. I’ve worked for eating disorder charities for many years, but these are just my opinions on the show and how they dealt with the topic.
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“Eating disorders can affect anyone of any shape or size.”
“Eating disorders don’t discriminate.”

You may have seen these statements online and most people would agree, right? But in reality, is this ethos really working in practice?

When plus-size model Tess Holliday spoke out about having anorexia, people on social media lost their minds. It seemed impossible for people to comprehend someone in a larger body restricting their eating. After all, our society teaches “eat less, move more” as the simple equation for weight loss, so there was an assumption that she must be lying because if she was really restricting, how could she possibly still be fat? Of course this resulted in a lot of online trolling for Tess, and in turn the underlying reinforcement of the idea that only thin people can have restrictive eating disorders.

When I say restrictive eating disorders, I’m referring to Anorexia and Bulimia. I think many people automatically picture a thin person, usually white, young and female, associated with these eating disorders. Often, fat people are associated with binge eating, but in reality thin people can binge and fat people can restrict. Many people aren’t familiar with the term OSFED - Other Specified Feeding or Eating Disorder – which is actually the most prevalent diagnostic category, because eating disorders don’t fit into tidy boxes like we expect them to. They are complex and nuanced; there’s no one reason someone develops an eating disorder (and all the many reasons are way too long to go into here!) Atypical Anorexia can come under this category, which is anorexia but at a “healthy” weight or above. The issue here is what is deemed as “healthy” is based on a flawed BMI system, created for white European men only, so it has been recognised as not an accurate predictor of health.
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There are also biases and assumptions of medical professionals, plus the limited resources on offer for eating disorder treatment, which often results in the “sickest” people getting help (i.e. thinnest). It’s a reactionary system, based on restoring someone's weight, though of course as eating disorders are to do with mental health, having a “healthy” weight does not mean the person has recovered. The short version of this is, the entire system is broken and people are not getting the help they need. (No disrespect to anyone working in the NHS, you’re just trying your best and I thank you for that.)

My focus is usually on the societal and cultural aspects of eating disorders and disordered eating. I use the term “disordered eating” as that includes people struggling with eating who don’t fit the diagnosis criteria too – of which there are a lot! I’ve worked for eating disorder charities for about 5 years now and I continue learning more every day. I’ve heard more and more stories over the years from people who are frustrated, unheard, not believed, passed off, sent to weight management services or Slimming World, and judged because they don’t fit what an eating disorder “should” look like. All of this is causing an incredible amount of harm, discouraging people from seeking help. Even writing this here, I’m concerned about creating more fear. Do we warn people of this and risk putting them off asking for help? Or is warning them needed so they can be prepared?
 
If you’re reading this and you’re considering reaching out for help with an eating problem, please still do – there are good people out there who can help you. If you don’t find one initially, see someone else. If you’re at a higher weight, a focus on anything to do with intentional weight loss will NOT be helpful so do set boundaries around this. You can refuse to be weighed too, or if they say they need to, tell them you do not want to know it. I tell healthcare providers that I do not want to know my BMI every time I visit and they are fine about that. I used to feel awkward about setting those boundaries, but with practice I now definitely don’t! Boundaries are self-care!
 
My work has led me to learn so much about people’s relationship with food, and to continue reflecting on my own. Everyone has a body, and everyone needs to eat, so it’s really important for professionals to consider their own relationship with food and their body. Sadly there is a lot of weight stigma, bias and discrimination in the medical world, in the therapy world, and…well, THE WORLD. Nobody is immune to weight stigma and fatphobia. When I talk about weight biases in the medical profession I don’t blame individuals but rather recognise that we’ve all grown up in a society that tells us thin is good and fat is bad. This is why unpacking and challenging weight stigma and fatphobia is so important. 

On an individual basis, the fear people hold about being fat is both deeply understandable and so saddening to me. There is no shame in holding these views, there is no shame in chaotic eating, or having tried every diet in the world, or having purged, and there is certainly no shame in having difficult emotions around food and your body. We live in a world where this is created and normalised.

If you’re in a larger body and you’re embarrassed or ashamed that you just can’t seem to lose weight or keep it off, please know that this is not your fault. Many people’s bodies just aren’t naturally made to be thin, and the focus on thinness often drives disordered eating. Sadly, this focus on trying to do something which supposedly makes you “healthy” is likely the very thing negatively impacting your physical and mental health. 
 
The fear driven by narratives such as “the ob*sity epidemic” is very real and can make some people terrified that being fat will kill them. It will not; fat is not the killer but rather associated illnesses, plus the stress and trauma of living in a world that terrifies people into unhealthy behaviours such as yo-yo dieting, disordered eating, eating disorders, compulsive exercise, self-harm and more. This fear is not driving change, it’s only making things much, much worse. Fat is not an evil thing to be eradicated, but weight stigma, fatphobia and discrimination is extremely harmful and needs to stop.

Many professionals will say that not all eating disorders are about body image and weight, which is true, however dieting is the biggest risk factor for an eating disorder. Dieting is often a result of wanting to lose weight to fit with the societal narrative of thinner equals healthier (not true), so it’s all rooted in weight stigma and fatphobia. Eating disorder professionals, medical professionals, therapists/counsellors, and other professionals working with anyone who may struggle with eating (which is A LOT of people) need to understand weight stigma and fatphobia for this reason. Many people are avoiding reaching out for help, being refused help, being wrongly diagnosed, and being judged for not being “thin enough” to have an eating disorder (sadly this is very common) so things need to change now.

When I see statements like “eating disorders don’t discriminate” it makes me think about how eating disorders can often be seen as a disease that suddenly grips people, as if in a bubble from the rest of the world. Eating disorders are created from, and influenced by, a world full of inequality and discrimination. We cannot separate the person from the society and culture that has shaped them. The eating disorder treatment world is largely white, middle-class and able-bodied (professionals and researchers, and well as patients) which means this is the centred experience and everyone else is potentially left out. Also, recognising that fatphobia has roots in racism (see Sabrina Springs' work) and the impact of transphobia too, in the wider context of a capitalist system… the people who need help the most are sadly so often the ones being failed.

Until we as a society can get our heads around the fact that most with people eating disorders are fat, AND that those people may also be black, trans, disabled, and/or a mix of identities, we will continue not to meet people’s needs. Saying “eating disorders don’t discriminate” is all well and good but sadly the systems designed to help and treat people often DO discriminate.
 
I offer training for professionals on weight stigma and disordered eating, and I run Body Acceptance Workshops for people wanting to improve their body image. Find out more here.

I am in the final stages of training as an Integrative Counsellor and I will be taking on clients in 2023. Please contact me to find out more.

​Bristol Waste are running a “slim my waste” campaign to encourage people to use separate food waste bins. On every wheelie bin, bright yellow stickers read “I’m on a no food diet” and tape measure style “slim my waste” stickers are wrapped around the middle section. A funny play on words? Not for the 1.6 million people affected by eating disorders in the UK. I’m all for food composting, but there must be better ways to do it than supporting toxic diet culture.

In a world where one in four 7-year-old girls have tried to lose weight at least once, it’s imperative that companies promote themselves responsibly. It’s reported that 70% of women have felt pressure from TV and magazines to have the perfect body. And it’s not just girls - 60% of people say they feel ashamed of how they look. Imagine having to walk past a line of wheelie bins, all decorated with tape measures, and having the words “slim my waste” stuck in your mind for the rest of the day.

After spotting a full page Bristol Waste advert on the back of The Spark (now run by Bristol 247) with the slogan “have you slimmed your waste yet?’ I decided to tweet Bristol Waste. 
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Their reply suggested other people had flagged it up as an issue too, and this was a copy-and-paste response. What they're effectively saying is “that wasn’t what we intended” and dismissing it as a problem because they don't think it affects people. Well, it does. Multiple people are telling them this. It is arrogant, irresponsible and unprofessional to dismiss it.

These bins are yet another thing people have to walk past every day demanding them to be thinner. Britain’s diet industry is worth billions of pounds - they profit off making people feel ashamed of their bodies. They tell us that beauty and health means being thin, which is simply not true. Healthy bodies come in all shapes and sizes. The diet industry need us to hate our bodies and aspire to be ‘perfect’ otherwise they wouldn’t make any money.

“Being sold the message of dieting can produce drastic dieting which can lead to eating disorders. Getting rid of dieting could wipe out at least 70% of eating disorders.” Dr Adrienne Key, Royal College of Psychiatrists.

Many people live with guilt and shame around food every day. Many struggle to feel worthy as a person because they’re not thin. They’re bombarded with digitally altered images, Slimming World leaflets through their front doors, adverts for gym memberships and diet pills, the voices of bullies on the street or on the bus. Every time they walk past one of these wheelie bins they’ll be reminded of how they’re not good enough. Bristol Waste is only a tiny part of this bigger cultural problem, but that doesn’t mean they can’t do something about it. To say these slogans are just a bit of fun is to completely deny somebody else’s struggle.

It’s never just a funny play on words. Slimming world use “syns” to describe treat foods because they know, psychologically, it won’t make any difference how the word is spelled. The word has the same effect in the mind - guilt and shame - the very thing that brings them more money. 
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​​I appreciate that Bristol Waste are trying to help us recycle and help save the environment. The funny face stickers for the food waste bins are fun and a great idea. However, the unwillingness to recognize the potential damage of the “slim my waist” stickers shows a complete lack of empathy towards another (large) group of people’s perspective. To deny the problem is to sit in a position of privilege and say “well, it doesn’t affect me”. Positive body image is integral to emotional and mental well-being and it’s crucial that companies and advertisers think carefully and take responsibility for their actions to help make a positive change for the future.

Disclaimer: I wrote these blogs a long time ago! I'm leaving them up as I don't want to delete my journey and I think showing growth is important. But it means that some of my views, and some language I use, is now different. Please be mindful of this, and that the content might be triggering, if you choose to read on.

Content warning: eating disorders
To The Bone is somehow listed as a 'comedy drama' on IMDB. It's certainly not a comedy. Writer/director Marti Noxon was apparently influenced by her own eating disorder experiences and wanted to help raise awareness of the illness. Whether it does this in the right way is up for debate, and I’m still not entirely sure myself. As much as I’ve had a very weird relationship with food and a rather negative relationship with my body in general, but I’ve not had anorexia so it’s not fair for me to question if the film portrays it well. Though of course it’s also subjective, so To The Bone may have been Noxon’s experience of anorexia but other people may have a very different reality of it.

Writing about mental health is tricky, especially for films. From my own experience of learning to write screenplays, it’s all about the three act structure and there’s an expectation to resolve all issues in the final act. This might be something relatively easy to do in a blockbuster action film (there's usually just a big fight and then the guy gets the hot girl) but when there are characters with complex mental health issues it’s hard to realistically resolve these in such a short time. In real life, unpicking trauma can take years. This, for me, was where To The Bone went wrong. There was a lot of focus on the illness (which is always risky as it can end up being a "how to" of eating disorders) and the recovery seemed to be done by way of a rather strange, quite rushed, epiphany sequence. And of course there was a boy involved too…uh oh….

There are only two notable male characters in this film and they hardly speak to each other. Technically you could say it passes the Bechdel test with flying colours. The Bechdel test asks if two women talk to each other about something other than a man, and although this was originally a useful test, it doesn’t stop women being overruled by men in films. In To The Bone, both men talk to her like crap, and their behaviour is never justified as such. It’s a particular gripe of mine when women are saved by men in films, but especially when it involves a mental illness. Often there just is no cure, another reason why it’s so hard to make a film which tells these stories in a satisfying, believable, responsible way. My first screenplay was about a young woman with depression and anxiety, and I’ve spent so long working on the ending to find that balance of it being hopeful but realistic. There are many ways people cope with having a mental illness but meeting someone and falling in love is often not the solution. This only puts pressure on another person to have to ‘fix’ them.  Strength comes from inside yourself, not from Prince Charming. This is obviously why I don't write romance!

Lilly Collins, who plays Ellen in To The Bone, apparently had an eating disorder herself. It’s no surprise then that she was brilliant in the role, but she did lose weight for it. We can’t say this was a bad choice on her part, because she’s a grown women and is responsible for her own body, but there’s no denying it was a risky move which might have potentially triggered her ED (eating disorder) again.

Whilst we’re on the topic of triggers, the film does have calorie counting, weight loss tricks, disordered eating etc, and there are triggering images. We can’t tell people with ED not to watch this film, it’s their choice and many of them will choose to because it’s relevant to them. As with 13 Reasons Why, all Netflix can do is make sure their audience is warned about the content, otherwise the responsibility lies with the audience. We also can’t say these kinds of films and TV shows shouldn’t be made, because otherwise how would we start a dialogue around them? If this film was banned, where would the line be drawn when it comes to other films?

On the other hand, there are dangerous images of thin women everywhere. For someone to play an anorexic woman in a film, she needs to be noticeably thinner than other women in films, and the ‘normal’ level is pretty bloody thin. It’s not hard to find ‘thinspiration’ in this world.

Some people with anorexia might want to be triggered. You only need to step into the world of ‘pro-ana’ (pro anorexia) websites and thinspiration (sometimes called ‘thinspo’, or even ‘bonespo’) to see that being triggered can be a good thing for them. Ultimately there might be a horrible irony to Lilly Collin’s choice to lose weight for the role in that she may become an unintentional thinspo idol.

In short, maybe this film is made for people who don’t know very much about eating disorders. There could be many benefits to parents or teachers, for instance, watching this to help recognise some things that people with anorexia may do. In this sense of raising awareness, maybe it works.

But let’s talk about Keanu Reeves. Keanu fucking Reeves. Personally, I think he has the screen presence of a lamppost. Apart from in the Bill and Ted films of course. (#NotAllKeanuReevesFilms)

But maybe it’s not all his fault in To The Bone. It’s a mix of:
a) the annoyingly privileged setting (they clearly got her into that residence ‘cos they’re loaded)
b) patriarchal bullshit
c) therapists always* being shit in films

*Okay, so therapists in films are not all shit (#NotAllTherapists) but they need to be recognised in the script as being shit if they are. Take, for example, Robin Williams in Good Will Hunting. He’s not set up to automatically be the one we should trust because he’s working through his own issues. This works. What doesn’t work is when you get a weird, creepy therapist like Keanu Reeve’s character in To The Bone, who is treated like some kind of cult leader. His behaviour is then validated at the end when she returns to the house, and we’re supposed to believe that it’s a positive outcome for her. It’s great that she chooses to take steps towards her recovery, but to go back to a place run by such a weird creepy bloke is simply bonkers.

Keanu/doctor/therapist/perv/cult leader is seen as radical because he says the word ‘fuck’ a few times. ‘Tell those negative thoughts to fuck off’ he says. So insightful and professional. Then he basically tells her to grow up and get over it, she goes away and has her little epiphany and then realises he’s right. The guy who thinks he can cure eating disorders by taking them to dance in some fake rain, is ‘right’ all along. She should’ve reported him, or at least gone to another clinic.

But then, the boy was there. Prince Charming. The pompous British twat who came on to her but then instantly body shamed her when she said no. The one who tried to force-feed her chocolate. The one who sat on a tree branch in her epiphany dream – the bit where she was dressed up like some kind of born again Christian angel virgin and he made everything all better by telling her she was pretty. Couldn’t the stepsister have been sitting on that branch with her, Ellen wearing her usual clothes? Can she not take steps to recovery without there being a man there to help, and without having to wear less eyeliner?

Then there was the mother and the moon. That strange, inappropriate feeding bit where her mother cradled her like a baby. I can see the theory behind that and it was nice to have a slight resolution to their seemingly turbulent relationship, but…really? And the moon…God knows. For a character who didn’t seem remotely spiritual, this ending was a little bit of a stretch for me. But the point is, she reaches the stage where she decides to follow the path to recovery. The intentions are good overall, and above all it’s a dialogue opener.

The strength of the film was certainly in it’s strong female characters and family dynamic, showing how eating disorders effect the whole family. I hope this movie helps people learn a little more about an under-represented topic in film and will open conversations about eating disorders and how we can help people and families affected.
 
If you or someone you know is affected by an eating disorder, here are some recommended websites:

https://firststepsed.co.uk/​firststepsed.co.uk/
https://www.b-eat.co.uk/