Obesity and eating disorders are usually seen as very different problems, but do they share some similarities? Being that it’s National Obesity Awareness Week, we though we’d try and answer that question!
Let’s start with the basics…
Eating disorders are serious and diagnosable mental health disorders that can significantly affect someone’s life, from the way they think and behave, as well as their physical wellbeing. Often eating disorders can include body image dissatisfaction and unhealthy coping behaviours to try to cope with stressful situations or other underlying mental health issues.
Unlike eating disorders, obesity is a physical issue generally caused by consuming more calories than you burn off through physical activity. It is an increasingly common problem with the rise in more sedentary lifestyles and spending a lot of time sitting down at desks, on sofas or in cars. A person of any age, gender or background can be obese due to a variety of factors, and individuals who are obese may also struggle with their mental health and low mood, with issues around stress or emotional eating, as well as lack proper knowledge on exercise and self-care.
Binge Eating and Obesity
Binge eating is common amongst people with eating disorders and people who are obese, and many researchers and bloggers have noted common characteristics between Binge Eating Disorder (BED) and obesity.
Binge eating disorder, or BED, is an eating disorder that can be described as eating large quantities of food over a short period of time, often in secret and without the use of compensatory behaviours. Someone who engages in binge eating episodes will also eat when they are not hungry, may eat until uncomfortably full, and will often eat alone.
People of all ages, genders and backgrounds can develop an eating disorder, and/ or struggle with binge eating. The factors which make someone vulnerable to this kind of behaviour are shared by people of all body sizes, and include things like yo-yo dieting, unhealthy weight-control behaviours, body image concerns, and self-esteem issues. Following a binge episode, the individual may have feelings of embarrassment or shame around the behaviour and any potential weight gain it may cause.
Conversely, feelings of shame, loneliness and poor self-esteem can also cause binge eating problems and contribute to weight gain and obesity. Here, the binge or overeating can be a coping mechanism for emotional reasons, including stress, depression, and anxiety.
Both Binge Eating Disorder and Obesity should be taken seriously, as both can affect both our physical and emotional health, however the treatment options for both can be very different. Unlike the treatment for eating disorder, when speaking to a doctor about obesity they will likely offer advice and treatments to help you lose weight ‘safely’. It is important that you find a responsible programme which can offer knowledge and support around gradual and sustainable weight loss (without any heavy restriction in terms of the types of food you can eat.)
Research shows that weight-loss treatments can contribute to the onset of disordered eating behaviours which may initially be misinterpreted as treatment benefits – physical activity and more discipline around food, afterall, would be viewed as positive outcomes from weight-loss interventions (as opposed to the increasing severity for individuals with eating disorders.)
Weight Stigma and Diet Culture
Another connection between eating disorders and obesity is the impact of stigma and exposure to diet culture.
Nowadays we are exposed to dangerous social expectations which recommend unsafe practices around food. Frequent exposure to these messages increases anxiety around ideal body shapes and weight and the development of unhealthy behaviours. From a young age, people are hearing that there is one way to eat, and that their bodies need to look a certain way to be a more ‘worthy’ person. This ideology stigmatises people with larger bodies and obesity.
You can learn a bit more about weight stigma on our blog, ‘Health, Weight Stigma & Fatphobia’, but what we mean here is the discrimination targeted towards individuals because of their weight and size, and most notably the negative beliefs associated with obesity. For people in larger bodies, society’s attitude towards obesity will often prevent them from exercising when or where they want to, increases existing negative thoughts around their weight and body image, and makes someone more vulnerable to developing an eating disorder. Even well-intentioned comments or advice can be part of weight stigma, from people saying they are concerned for people’s “health”.
This level of discrimination can be extremely hurtful and since the Equality Act 2010 doesn’t cover size, it’s not illegal to discriminate against people in larger bodies. Instead, society continues to stigmatises weight, the number of people at risk of developing an eating disorder continues to rise, as well as body image issues and mental health problems throughout the UK.
It is no surprise that many people feel locked in a vicious cycle of dieting and binging, which is something that the government’s anti-obesity strategy will not fix, sadly it may only create more of a problem.
The government’s anti-obesity strategy
The government’s anti-obesity strategy was introduced to tackle the high rates of obesity in the UK, believing that the issue is down to a lack of knowledge and accessible information around the calories in our food. It was believed that simple ‘nudges’ (such as calorie content on menus) will encourage long-term obese or overweight people to build a more informed relationship with food, lose weight and be ’healthy and happy’.
Whilst their intentions might be pure, previous public health campaigns have been ineffective in addressing obesity and without recognising issues around stigma and any other underlying issues surrounding mental health and body image we don’t hold too much hope for any upcoming government initiatives.
Many commentators on the new measures, note that hyper-focus on calories and certain food groups will only increase stigma, and those already vulnerable to developing an eating disorder will be more at risk. Whilst it is important address the high rates of obesity, we need to do so without ‘criminalising’ the overweight and to do that we need to take an integrated approach to the obesity strategy. The government need to call on leading experts in obesity and eating disorders, as well as people with lived experience to be a part of the discussion. To develop effective legislation, the government needs work harder in their exploration and understanding of restrictive diets, exposure to calories and nutritional information and unsustainable diets and how they can contribute to someone developing an eating disorder.
Alas, on July 22nd 2021 the UK Parliament passed legislation introducing mandatory calorie labelling on menus in all restaurants, cafes and take-aways with over 250 employees in England from April 2022, despite there being limited evidence that it will have the intended outcome. If this something you are worried about, visit Beat’s website to learn more about their Public Health Not Public Shaming campaign, as well as their guidance on eating out with calorie labels on menus.
So, what’s the answer?
When offering support, or when seeking out treatment, it is important to be aware of the similarities between obesity and an eating disorder. Both issues can be complex and serious and they may require ongoing professional support, therapy, nutritional education, and peer support to overcome.
The relationship we have with food can be incredibly complicated, and maintaining a healthy relationship (as with any relationship) takes work over a long period of time so if it’s something you’re struggling with, we should all be able to ask for help, regardless of what size we are. The government’s current obesity campaign emphasises personal responsibility, stigmatising those who have a more complex relationship with food and body image. Their strategy ignores so many factors such as underlying health conditions, socio-economic factors and other obesogenic factors (which, in short, means increased availability of food and less opportunity or incentives for moving around.)
We should be developing effective legislation and programmes that have proven, long-term impacts on people’s predisposition to binge-eat and overeat. There is also opportunity here to evolve and invest in better treatment for eating disorders, and involve experts and those with lived experience in designing new policy.
We need a new narrative. We need to start reject diet culture, and the belief that our bodies and appearance define our worth. We need to boycott mass media and any messages which normalises negative body image and encourages disordered eating. We need to normalise self-care and acceptance. We need to change, together.
So, this National Obesity Awareness Week, let’s think about obesity and it’s connection to eating disorders, afterall, they are not separate issues.
Body size and eating disorders are interrelated, and obesity can be both a risk factor for developing an eating disorder as well as a possible outcome for people struggling with eating disorder behaviours. Instead of encouraging the large number of people who are dissatisfied with their bodies to engage in unhealthy ways to lose weight, let’s promote body acceptance. Body diversity is a fact of life, and we should be more accepting of ourselves and others.
For support around body image, don’t forget to check out our ‘Understanding Body Image‘ three-part guide.