What’s missing from the conversation about eating disorders?

When you hear the term ‘eating disorder’, what comes to mind?

Is it anorexia?

Or maybe bulimia?

It’s not surprising.

When someone asks me what I do and I explain I’m a psychotherapist who works with clients with eating disorders, they usually tell me about someone they know who’s experienced anorexia.

While it’s a really good thing that awareness around anorexia and bulimia has increased significantly over the years, there’s yet to be the same level of awareness about binge eating disorder or OSFED.

In case you don’t know, OSFED stands for “other specified feeding or eating disorder”.

Any disordered eating – for example compulsive eating or emotional eating – that doesn’t meet the criteria for binge eating disorder, bulimia or anorexia, usually falls under the category OSFED.

It doesn’t mean the eating behaviour is less distressing, it simply means it doesn’t meet the criteria.

So what’s the most prevalent eating disorder in the UK?

The answer is OSFED.

Followed by binge eating disorder,

…then bulimia,

…then anorexia.

Anorexia has the highest mortality rate of any psychiatric disorder in adolescence but it’s the least prevalent eating disorder.

OSFED and binge eating disorder are the most common eating disorders and yet they’re often left out of the conversation.


A new study published in The Lancet this month found that 41.9 million cases of binge eating disorder and OSFED were unreported in 2019, because the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) includes only anorexia and bulimia.

As a result, the experiences of 41.9 million people simply weren’t taken into account.

Binge eating disorder wasn’t included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) until 8 years ago in 2013.

If you go to your doctor concerned about binge eating or any other form of emotion-driven overeating, the sad fact is you’re more likely to be given diet advice than an eating disorder assessment.

No wonder so many of the clients I work with struggle to believe they’re worthy of help.

It’s time to be better informed about binge eating disorder and OSFED.

It’s time to ensure people suffering with these issues get the help they so badly need and deserve.

It’s time to change the conversation.

©️ Julie de Rohan 2021.

Mental Health and Weight Loss Ads

I was recently asked to contribute to an article on the mental health impact of weight loss advertising for Metro.

You can read the article here, but I also wanted to share with you the questions I was asked and the answers I gave.

Continue reading “Mental Health and Weight Loss Ads”

Dieting is Never the Answer

This is the time of year when most New Year diets have failed.

Yes, The Eating Silly Season is coming to a close. To be fair, Eating Silly Season is now all year long, but in January it’s especially silly as Diet Culture stages its annual Grand Parade of Bullshit and Misinformation.

Look – there’s that “celebrity doctor” shamelessly promoting disordered eating on social media in the name of “science”. There’s that “diet guru” on TV forcing people who are Not Thin to lose weight rapidly with zero regard for their psychological wellbeing.

Then there’s you.

How are you doing with all of this?

Continue reading “Dieting is Never the Answer”

Why the UK Government is Getting it Wrong on Obesity

The Guardian recently reported the UK Government is planning to launch an “emergency drive” to reduce obesity rates in anticipation of a second Covid-19 wave later this year.

There’s concern Coronavirus disproportionately affects overweight and obese people. According to the article, the Government programme will be “based on encouraging people to reduce their calorific intake and lose weight rapidly”.

If accurate, the UK Government is acting on a dangerously incorrect assumption – that obesity is purely a physiological, rather than a psychological, issue.

It’s a mistake that’s made often.

Continue reading “Why the UK Government is Getting it Wrong on Obesity”

Expert Insight: Dieting and the Fear of Famine

“Our ancestors did not have a constant supply of food. When a large animal – a whale, a bison, a woolly mammoth or an elephant – was killed, everyone feasted, gorged… it might be weeks or months before another big kill, so large amounts had to be eaten quickly and then stored in the body for the times of scarcity that were sure to come.  

This is an ancient or atavistic memory that calls us to eat all we can now, even if we are not hungry, just in case there won’t be any food tomorrow… there is something deep in our primitive brain that still fears starvation, scarcity, famine.”

Jan Chozen Bays, “Mindful Eating”

Remember the panic-buying we witnessed when the Covid-19 crisis first hit?

Continue reading “Expert Insight: Dieting and the Fear of Famine”

A World Without Dieting

If dieting never existed, what would your relationship with food be like?

Just think about it for a minute.

How would you eat if you’d never learnt to diet?

Would you wake up feeling confused and stressed about food?
Would you feel guilty and ashamed about eating something you “shouldn’t”?
Would you still binge? Label food as “good” or “bad”? Hate your body?

Continue reading “A World Without Dieting”