Eating Disorders

An eating disorder is a clinical diagnosis, usually as per the DSM-5. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication by the American Psychiatric Association (APA) for “the classification of mental disorders using a common language and standard criteria.” I won't break down all of the different eating disorders here as there is plenty of information out there, a comprehensive one is this one by BEAT.

The criteria can seem narrow, and eating disorder services are under-funded and under-resourced, so sadly people are turned away from NHS services. This can be harmful to many people as this may exacerbate the eating disorder, may leave them feel unsupported and alone, and there can be a risk of other aspects of mental health deteriorating. This may especially be the case for people at higher weights as sometimes disordered eating can be overlooked and they can be referred to weight management services. This potentially will cause a lot more harm and only fuel the stigma, shame and eating behaviours.

Weight stigma and fatphobia sadly play a part in the diagnosis and treatment of eating disorders. Medical professionals have grown up in the same diet culture and idealization of thinness, so they hold their own unconscious biases and ideas of what an eating disorder "should" look like. You can read more of my views of this on my blog page.
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Disordered Eating

"Disordered eating" is a term used to describe eating problems that may not fit the eating disorder categories, involving any distress and/or anxiety caused by eating. I often use "disordered eating" as a term to include eating disorders too, as a broad term to describe all kinds of eating distress. The eating disorder criteria is quite narrow, so referring to "disordered eating" for me feels more inclusive to everyone. "Eating distress" also is more inclusive and may fit better for people who may not like the term "disordered". Ultimately, it's best to use the term that feels right for you. 

The following list contains examples of what *may* be included in disordered eating, however *may* is the important word here as everyone is different and it is always within a contact of the person as an individual. Some people may diet occasionally, whereas others may diet and it may escalate. The difference between "normal" eating (if there even is such a thing), disordered eating and eating disorders, is to do with the severity, how often, how much etc, but this is always to be determined on a case by case basis.
I do not diagnose people, I look beyond the label, though I respect that labels are very important for many people. The most important thing for me is that ANY kind of eating distress is really difficult and can have a really huge effect on people's lives.

​Everyone deserves help and support.

Examples of Disordered Eating

• Anything that causes distress – guilt, anxiety, fear
• Being preoccupied with food
• Rigid rules around food and eating
• Binge eating (which doesn’t fit the criteria for BED)
• Purging – including using laxatives & diuretics
• Focussing on numbers -  eg calorie counting, weighing food
• Using weight loss supplements, teas, diet pills etc
• Yo-yo dieting
• Restricting food groups (non-allergy related)
• Cleanses/fasting
• Being fearful of foods, only eating “safe” foods
• Over-exercising/compensatory exercise, exercising whilst injured or tired
• Using anabolic steroids
• Feelings of guilt/shame if unable to exercise
• Food avoidance due to sensory factors
• Avoiding eating around other people
• Regularly weighing yourself

There are likely more ways that disordered eating shows up, it's different for everyone. But however it shows up, it's important to seek help and support, even if you don't think your problem is as bad as other people's. You still deserve help and support.

If you're in a larger body you may feel judged, shamed or unheard by professionals. As someone in a larger body myself, who also had a difficult relationship with food and my body, I hear you. Weight stigma and weight discrimination is tough to live through, I'm here to be a listening, non-judgemental ear for you, should that be what you need.

I try to be as adaptable and collaborative as I can be in how I work with my clients. Everyone's story is so unique. I will never, ever ask you to fill out a food diary, ask you for your weight (unless there might be a risk to you that would require us having that conversation) and I'll never judge you for your food or any of your choices. There's already enough of that sort of stuff in the world!

If you'd like to enquire about counselling sessions, or have any questions, please get in touch using the form below.