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Obesity and eating disorders are not separate issues

Katy experienced binge eating disorder in 2017. Following the recent launch of the government’s anti-obesity strategy, which led to the launch of our Public Health Not Public Shaming campaign, Katy shared her thoughts on the strategy and what she feels should be done differently.

I can say now with confidence that the government’s obesity strategy is not going to work. It’s based on the premise that the high rates of obesity in this country are down to a lack of information and knowledge about the calorific content of the food that we eat, and that simple ‘nudges’ such as calorie content on restaurant labels will somehow encourage people who’ve been overweight or obese for a long time to finally ‘shed those pounds’ and be healthy and happy.

If only that were that simple. I’m not denying that reducing calorie intake is likely to result in weight loss. Indeed, I’ve used calorie information to lose weight multiple times. Guess what? I gained the weight back on every time. That’s because such restrictive diets do not work in the long term. And don’t just take my word for it – all the evidence says the same. A meta-study by the BMJ in April 2020 revealed that, while most popular diets result in weight loss in the short term, any effects disappear within just one year.

Worse than this, dieting can lock people into a dangerous relationship with food that can result in eating disorders. Contrary to popular conception, the vast majority of people with eating disorders are not underweight. In fact many are obese. Dieting to lose weight quickly was one of a number of factors that led me to develop binge eating disorder (I’ve written more about my experience of binge eating disorder here).

Obesity and eating disorders are not separate issues. They are intimately connected. I would bet a decent amount of money that a large portion of people in the UK who would be deemed obese have already tried dieting, are hyperaware of the calorie content in most foods, and many are probably locked in a vicious and demoralising cycle of bingeing and dieting that the government’s strategy will not fix.

There is a dearth of research into the prevalence of binge eating disorder in the UK but the evidence we do have (much of it from Christopher Fairburn) suggests that about a quarter of adults trying to control their weight have binge eating disorder.

The ‘nudge theory’ on which the government’s strategy relies will not work to end obesity because our relationships with food are incredibly complex and obtaining and maintaining a healthy weight requires an enormous amount of work and energy over a long period of time, including the help and support of trained mental health professionals.

If the prime minister were serious about lowering rates of obesity, he would invest his time and energy into programmes that have proven, long-term impacts on people’s propensity to binge-eat and overeat. This means investing in programmes for people with eating disorders, involving eating disorder experts in designing policy, and moving away from stigmatising and shaming language and campaigns that will only drive more people into the dieting-bingeing cycle. 

Contributed by Katy