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.