Specialist focus
Eating disorders and disordered eating
An eating disorder is a mental illness, not a diet that went too far. The part anyone can see (whatever is happening around food), is the smallest part of it and usually the last to change. What holds it in place sits underneath, and that is what treatment works on. You do not need a diagnosis, or a certain level of severity to start.
The types of eating disorder
Anorexia nervosa
Anorexia is not a choice, not vanity, and not something a person can simply be reasoned out of. It can develop a logic of its own, one that may feel protective, safe or necessary from the inside, while gradually narrowing life from the outside. This is part of what makes anorexia so difficult to challenge, and why treatment works with the fears, beliefs and patterns holding it in place, rather than simply asking someone to eat.
Read more about anorexia nervosaBulimia nervosa
Bulimia often runs in a loop that can feel almost impossible to interrupt from the inside. Restriction, rules around food, binge eating, compensatory behaviours, guilt and the promise to “do better tomorrow” can each feed the next part of the cycle. Treatment is not about being told to stop or finding more willpower. It is about understanding what keeps the loop going and gradually breaking it in the places where change becomes possible.
Read more about bulimia nervosaBinge eating disorder
Binge eating disorder is a recognised eating disorder, not a failure of willpower or self-control. Binge eating often sits within a cycle of restriction, difficult emotions, eating that feels out of control, and the shame or renewed rules that follow. Treatment works by understanding what is driving and maintaining that cycle, rather than asking you to simply try harder to stop.
Read more about binge eating disorderOSFED
OSFED stands for Other Specified Feeding or Eating Disorder. It describes eating difficulties that are clearly an eating disorder but do not fit neatly within the diagnostic criteria for anorexia, bulimia or binge eating disorder. It is common, can be every bit as serious, and does not mean that you are “not unwell enough” for treatment. Eating disorders rarely read the textbook.
Read more about osfed
You do not have to be certain to get in touch.
Most people who contact me have spent a long time wondering whether their difficulties really count. That question “am I unwell enough for this”?, is one of the most common features of an eating disorder. It is also one of the most reliable reasons people wait years before asking for help. There is no threshold you have to cross first. If food and thoughts about eating are taking up more space than you want them to, that is enough reason to ask for help.
An eating disorder is a mental illness. The visible part — whatever is happening around food — is the smallest part of it, and usually the last part to change. Underneath sits a way of thinking that has become very loud: a set of rules that felt manageable at first and then began to expand, a running commentary that is difficult to argue with, and a sense that following it brings relief.
That relief is the reason eating disorders are so hard to put down, and it is the hardest thing to explain to people who love you. From the outside it can look like self-destruction. From the inside it can feel like the one thing holding you steady. Both are true at the same time, and any therapy worth doing has to be able to hold both.
Eating disorders are not a lifestyle choice, not vanity, and not something a person can be reasoned out of. They occur in people of any age, gender, ethnicity, sexuality, background or body size.
When it does not have a name
Not everyone who struggles has a diagnosis, and not everyone wants one. You might be someone whose eating is governed by rules other people do not seem to have. You might think about food more than you would like and rather less than you would admit. There may be stretches where it is fine and stretches where it takes over everything.
None of that has to become severe before it is worth addressing. The earlier it is addressed, the less of your life it occupies.
What we would actually do
I work with the thinking that keeps the problem running, not only with what happens at mealtimes. In practice that means building a shared picture of how it works for you specifically: what sets it off, what it does for you, what it costs you, and where the loop can be interrupted. It is structured and it is collaborative. You will always know what we are working on and why.
Sessions are online, which for a lot of people is the difference between starting and not starting. Change tends to be gradual and it is rarely a straight line. Progress is still progress on the weeks it does not feel like it.
Psychological & nutritional care
Looking at the whole picture
Eating disorder treatment sometimes needs to address both the psychological patterns keeping the difficulty going and what is happening around eating itself.
My background in Clinical Nutritional Therapy allows me to bring these pieces together where appropriate, while keeping the psychological work at the centre of treatment.
Where additional medical or specialist input is needed, I work collaboratively with the other professionals involved in your care.
Recovery is possible. I will not promise you that it is guaranteed or give you a timeline. What I can tell you is that people do recover, fully and lastingly, and that getting help makes that considerably more likely than waiting does.
If you are a parent, partner or friend
Living alongside someone with an eating disorder can be exhausting and frightening. Often, the instincts that would normally serve you well, such as reassuring, reasoning, persuading or trying to fix things do not seem to work.
A few things can make a meaningful difference. Try to separate the person from the eating disorder, both in your own mind and in the way you speak to them. Stay steady rather than joining the argument they may already be having internally. And look after yourself too. Recovery can take time, and supporting someone is much harder when you are running on empty.
You do not need to have all the right answers. Being a calm, consistent and compassionate presence matters more than saying the perfect thing.
Questions people ask
Do I need a diagnosis before I can start?
I have had treatment before and it did not work. Why would this be different?
Will you tell me what to eat?
I am not sure I actually want to change. Is there any point coming?
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If you would like to talk about what you are looking for, please reach out. There is no pressure and no threshold you have to cross first.