Eating Disorders in Transgender and Gender Diverse Communities

A growing body of research highlights that transgender (trans) and gender diverse people face a heightened risk of eating disorders. Studies estimate that up to 23% of trans young people experience a current or past eating disorder, compared to a lifetime prevalence of 10.5% in the Australian general population. Recent data indicated that 18% of trans young people reported an eating disorder diagnosis, which is significantly higher than the 1.8% of cisgender young people reporting a current eating disorder (1.8% women and 0.2% men). While research in this area remains underdeveloped, the statistics highlight the need for trans-inclusive and gender affirming eating disorder treatment.

Factors which can contribute to Eating Disorders for Trans and Gender Diverse people

In addition to the commonly recognised environmental, genetic, and personality trait factors which can contribute to an eating disorder, trans and gender diverse individuals may face unique, additional factors.

Gender Dysphoria

Gender dysphoria refers to the significant distress that can arise when a person’s gender identity does not align with the sex they were assigned at birth. This distress can strongly influence how someone relates to their body, especially in the context of eating and appearance.

• For some, eating disorder behaviours may be used as a way to modify their body—such as altering body composition, suppressing secondary sex characteristics, or delaying puberty—to feel more aligned with their gender identity

• These behaviours may also serve as a coping strategy to numb or distract from emotional distress, or as a form of self-punishment linked to internalised stigma or shame

• The pressure to 'pass' as a particular gender due to societal norms and expectations can increase body dissatisfaction, particularly when bodies do not conform to cisnormative standards

• Gendered social norms have also influenced ideals of androgynous bodies, which like stereotypes of masculinity and femininity can be narrow, restrictive and limiting

These complex dynamics make it critical that eating disorder treatment is equipped to sensitively and competently address the emotional and physical aspects of gender dysphoria.

Transgender IdentitY and AFFIRMATION

Being transgender refers to identifying with a gender that is different from the sex assigned at birth. While being trans is not inherently linked to eating and body image concerns, the societal and internal challenges that many trans people face can contribute to risk for eating disorders. Navigating gender identity in a cisnormative world can create distress around the body, especially when it does not align with one’s gender. For some, eating disorder behaviours may be used to gain a sense of control, reduce the visibility of unwanted gendered features, or cope with stigma and exclusion.

Gender affirmation can include social transition (e.g. changing pronouns, name, clothing and appearance); legal transition (e.g. updating name and gender marker on legal documents such as birth certificate); and medical transition (e.g. hormone therapy, puberty blockers and gender affirming surgeries). It’s personal to each trans and gender diverse person which forms of affirmation they choose to engage with, and all choices are valid.

As one example, hormone therapy, such as oestrogen or testosterone, can be an important part of gender affirmation and may have a powerful impact on body image and eating concerns. For the majority, gender-affirming hormones help reduce dysphoria and promote a stronger sense of self, supporting more positive relationships with food and the body. It is important to be aware that the physical and emotional changes brought about by hormones can also be complex and emotionally charged, especially if expectations are unmet or if access to care is inconsistent or unsupported. These dynamics can influence how someone experiences their body, sometimes in ways that intersect with eating disorder thoughts or behaviours.

Lack of representation, affirmation, and understanding from health professionals can further compound these difficulties, highlighting the importance of inclusive and informed care.

Minority Stress

Minority stress refers to the unique and chronic stressors faced by people from marginalised communities, such as trans and gender diverse individuals. This includes experiences of discrimination, stigma, exclusion, and systemic inequity. These stressors can significantly impact mental health and are linked to an increased vulnerability to eating disorders.

• Navigating systems that invalidate or marginalise gender identity can lead to persistent stress, which can in turn trigger or exacerbate eating disorder symptoms

• Potentially concerning eating behaviours may emerge as a coping mechanism—offering a sense of control, emotional regulation, or escape from the distress of discrimination

• Some people may engage in eating disorder behaviours as a form of self-protection, for example by modifying their body to 'pass' and avoid transphobic harm or to delay coming out in an unsafe environment

• Limited access to safe and affirming gender-affirming care can increase distress and the risk of relying on coping behaviours to manage gender dysphoria

• Internalised transphobia, resulting from ongoing exposure to societal rejection or marginalisation, can negatively impact self-worth, body image, and overall psychological wellbeing in all areas

Protective Factors

While the relationship between gender, body image, and eating behaviours can be complex, it's important to recognise that trans and gender diverse people can also be supported by meaningful protective factors. These can act as buffers against the development or progression of eating concerns and promote overall wellbeing.

• Access to all forms of gender-affirming care (including social, legal and medical affirmation) is consistently associated with reduced risk and severity of eating disorder symptoms. Feeling more aligned with one’s gender can lessen distress and support a more positive relationship with the body

• Strong social support and connection—whether from friends, family, or community—can improve mental health outcomes, reduce isolation, and create a sense of safety and belonging

• Being part of affirming gender-diverse communities can help challenge harmful beauty standards and binary gender ideals. These spaces often foster acceptance, authenticity, and empowerment, allowing people to express themselves without pressure to conform

What is Trans and Gender Inclusive Eating Disorder Therapy?

Trans and gender inclusive eating disorder therapy recognises the unique experiences of trans and gender diverse people and ensures that care is affirming, respectful, and responsive to each individual’s gender identity. This includes using correct names and pronouns, addressing the impact of gender dysphoria and minority stress, supporting access to gender affirming care, and avoiding assumptions based on binary gender norms. Therapy may also explore the intersections between body image, identity, and eating behaviours in a safe, non-pathologising way. Inclusive treatment is grounded in collaboration, validation, and empowerment—supporting clients to explore their relationship with food, their bodies, and themselves without judgement.

At Mind Body Well, we are committed to providing safe and affirming healthcare for LGBTQIA+ communities. If you are seeking support, we recommend reaching out to see a Psychologist or Dietitian on our team, all of whom have experience in gender diversity and eating concerns. We also recommend the following support services:

• QLife - provides free daily peer support from trained members of the LGBTIQA+ community Australia wide via anonymous phone and webchat

• Rainbow Door - a free helpline providing information, support, and referrals for LGBTIQA+ Victorians

• Eating Disorders Victoria BLOOM support group - BLOOM is a fortnightly group run by Eating Disorders Victoria for LGBTIQA+ people with eating disorders

References

• https://eatingdisorders.org.au/eating-disorders-a-z/eating-disorder-statistics-and-key-research/

• McGregor, K. et al. (2023) ‘Disordered Eating and Considerations for the Transgender Community: a Review of the Literature and Clinical Guidance for Assessment and Treatment’. Journal of Eating Disorders, 11(75)

• Cusack, Claire E. et al (2022) ‘“I’m Still Not Sure If the Eating Disorder Is a Result of Gender Dysphoria”: Trans and Nonbinary Individuals’ Descriptions of Their Eating and Body Concerns in Relation to Their Gender’. Psychology of sexual orientation and gender diversity, 9(4)

Are you Actively or Passively Restricting your Food Intake?

Periods of inadequate or irregular eating can occur for a multitude of reasons, including food restriction. A common feature across many eating disorders, food restriction involves limitation of the variety, adequacy or regularity of the foods that we eat. Food restriction may occur as a result of active and deliberate attempts to reduce dietary intake, or it can arise more subtly - due to a lack of conscious attention to meeting our nutritional needs.

Active Restriction

Active restriction involves conscious, intentional efforts to limit or control food intake, often driven by specific goals or fears related to weight, body shape, or food itself. Common examples of active restriction include:

• Selective eating: Avoiding foods deemed ‘unhealthy’, often leading to rigid food rules and reduced variety of ‘safe’ food options

• Weight loss dieting: Following prescribed plans with a goal to lose weight, which often involves tracking and limiting daily intake to stay within a set target (eg. calorie counting)

• Fasting: Skipping meals or going extended periods without eating to reduce overall food intake

For people experiencing an eating disorder, active restriction is often associated with Anorexia Nervosa (significant and prolonged food limitation motivated by an intense desire to control body weight and shape). However it is important to recognise that active restriction is central to almost all eating disorders, including Bulimia Nervosa and Binge Eating Disorder, where restriction fuels reactive cycles of binge eating (and potential compensatory behaviours).

Passive Restriction

Passive restriction, on the other hand, occurs less intentionally. People who are restricting in a more passive way may not actively try to limit their food intake, but lack the drive to eat due to a variety of factors, such as:

• Forgetting to eat: Skipping meals unintentionally, often due to preoccupation with work, life stress, or distraction with other activities

• Lack of appetite: Reduced hunger cues, which may stem from psychological and emotional  factors such as low mood or heightened anxiety, or physical factors

• Health Conditions: Chronic illnesses, digestive issues, or some medications can reduce appetite and cause people to go extended periods without food

• Sensory sensitivities: Avoiding certain foods due to characteristics such as texture, taste, or smell, making it difficult to eat a balanced diet

While not always related to an eating disorder, passive restriction can be a characteristic of Avoidant/Restrictive Food Intake Disorder (ARFID), particularly when caused by sensory sensitivity. Passive restriction can also be related to other eating disorders - for example, when someone unconsciously welcomes opportunities to ‘forget’ to eat, or downplays their nutritional needs.

Food Scarcity and Restriction

Food restriction can also be influenced by external factors such as food scarcity. Limited access to adequate nutrition due to financial constraints or unpredictable food availability can lead to involuntary restriction. This is important to understand as a separate factor to other forms of restriction, as it necessitates strategies to improve food access and the consistent availability of adequate nutrition.

Can Active and Passive Restriction Overlap?

Although these forms of restriction can seem distinct, they do often overlap. Someone who initially experiences passive restriction (such as skipping meals due to low appetite) might develop active restriction over time, given inadequate dietary intake can be a trigger for the development of an eating disorder.

Similarly, an eating disorder can disguise itself as passive restriction, making disordered behaviours harder to recognise. For example, someone experiencing an eating disorder might frequently say they’re “too busy to eat," when in fact this has become a way to justify restriction.

Addressing Restriction in Recovery

It’s important to be curious about and to understand what’s motivating restrictive eating behaviours, in order to then decide on the best course of treatment. Both Psychologists and Dietitians experienced in eating disorder therapy can assist with this, and Dietitians in particular can assist in recommending strategies to focus on more adequate nutritional intake.

Active restriction often requires addressing thoughts, fears, and beliefs about food and body image. Passive restriction may call for strategies to support appetite awareness, manage sensory sensitivities, or to build regular eating habits. Both types of restriction can benefit from therapeutic assessment, strategies and support to change, which our team at Mind Body Well are able to provide.

The Art of Active Listening: Transform Your Conversations

How active listening can transform your communication

Active listening is a powerful communication skill that enhances both personal relationships and professional interactions. Instead of the common habit of half-listening while formulating a response, active listening encourages us to fully engage with what is being said, leading to deeper understanding and stronger connections.

What is active listening?

Active listening means being fully present with the speaker and genuinely processing the information being communicated. Simply hearing someone does not equate to truly listening. Hearing is a passive process—our brain perceives sound without necessarily engaging with it. Listening, however, is an active process that requires attention, comprehension, and effort to truly understand what the speaker is trying to convey.

Why is active listening important in communication?

Active listening plays a crucial role in strengthening relationships and building trust. When we truly listen, we show empathy, respect, and appreciation for the other person’s perspective. This fosters mutual understanding and enhances relationships with partners, family members, friends, and colleagues.

In professional settings, active listening is essential for effective leadership, teamwork, and collaboration. Managers who actively listen to their employees create an environment where individuals feel heard and valued, leading to greater job satisfaction and productivity.

The key principles of active listening

To master active listening, consider these five key principles:

1. Pay attention
   Give the speaker your undivided attention, free from distractions. Observe non-verbal cues like body language and facial expressions to fully grasp their message.

2. Show that you’re listening
   Maintain eye contact, nod occasionally, and use encouraging cues like "yes" or "uh-huh" to demonstrate your engagement.

3. Provide feedback
   Reflect on what the speaker has said by paraphrasing: "What I’m hearing is..." or "It sounds like you’re saying..." Asking clarifying questions can also help ensure you understand correctly.

4. Defer judgment
   Resist the urge to jump to conclusions or interrupt. Give the speaker space to fully express their thoughts before forming your own response.

5. Respond appropriately
   When it’s your turn to speak, be honest and respectful. Even if you disagree, responding thoughtfully fosters meaningful dialogue.

Barriers to active listening

Several factors can hinder active listening. Being aware of these barriers can help you overcome them:

• Environmental distractions – Noise, technology, and physical obstacles that interfere with communication.

• Stress – High stress levels can make it difficult to concentrate and absorb information.

• Personal biases – Preconceived notions, cultural differences, and personal experiences can influence how we interpret what is being said.

How to practice active listening effectively

Like any skill, active listening requires practice and patience. Here are some strategies to help you develop it:

• Be present – Remove distractions, put your phone down, and focus on the speaker.

• Stay curious – Approach conversations with an open mind and ask follow-up questions.

• Find common ground – Engaging in topics of mutual interest can help sustain meaningful dialogue.

Real-life examples of active listening in action

1. Improving relationships
   A couple discusses a recent disagreement. One partner actively listens by setting aside distractions, making eye contact, and refraining from interrupting. They summarize what they heard before sharing their own perspective, fostering better understanding and compromise.

2. Navigating workplace feedback
   An employee receives constructive criticism from their employer. Instead of reacting defensively, they actively listen, ask clarifying questions, and acknowledge the feedback. This leads to a productive discussion on improvement strategies and professional growth.

Active listening is a transformative skill that enhances both personal and professional relationships. By being fully present, demonstrating engagement, and responding thoughtfully, you can create deeper connections and improve communication in all aspects of life.

Wishing you a Non-Diet New Year

As the year comes to a close, we may find ourselves reflecting on the months that have passed, and contemplating changes we’d like to make in the year ahead. This time of year is ‘peak season’ for the diet industry, as they expose us to a plethora of messages trying to convince us that our lives would be better, our happiness more achievable, if only we lost weight - which is of course, a very long way from the truth.

This year, we encourage you to break free from diet culture, and to focus on setting positive, sustainable goals which contribute to self care, nurturing, and physical and psychological wellbeing. Here are five strategies to consider as you approach the new year:

1. Unplug from Negative Influences

Social media has become an integral part of our lives, and has a significant impact on how we view ourselves. While it can be a great tool for connection, it can also amplify feelings of inadequacy, especially when we’re exposed to content which reinforces unrealistic beauty standards or unhealthy and unsustainable lifestyle expectations. Take a moment to evaluate the social media accounts you follow. If certain influencers, celebrities, or posts make you feel bad about your body or your lifestyle choices, it’s time to unfollow. Curate your feed with content that uplifts and inspires you. More puppies and kittens, and less ‘wellness’ influencers. Create a social media environment which nurtures your mental wellbeing, rather than detracting from it.

2. Break Free from Food Rules

Food rules are beliefs or values which dictate how, when, and what we eat. Food rules can be restrictive and damaging, creating feelings of guilt or shame when we don’t follow them. Challenge these rules can create a shift towards a more intuitive approach to eating. Allow yourself to eat what you genuinely want and need, instead of what you think you ‘should’ eat. Remember, food is not inherently good or bad; it’s a source of nourishment and enjoyment. Shift your mindset by using neutral and non-judgemental language with food, seeing food as fuel for your body rather than something to fear or control.

3. Cultivate Self-Compassion

We are often our own harshest critics, especially when it comes to our bodies and our actions. We may easily show kindness to others, but extending that same compassion to ourselves can be much harder. Yet, self-compassion is a cornerstone of mental and emotional wellbeing. If you’re looking for a meaningful New Year’s resolution, start by practicing self-compassion. Even if your thoughts are not yet filled with self kindness and compassion, take steps to build this very important psychological habit. Whether it’s making time for regular self-care rituals or speaking kindly to yourself when you make mistakes, these small steps can help build resilience and a deeper sense of self-worth. Put yourself on your priority list this year—schedule activities which nurture your mind, body, and spirit.

4. Prioritise Quality Sleep

In everyday life, it’s easy to de-prioritise sleep for other competing demands. Given quality of our sleep directly affects every aspect of our health—physical, mental, and emotional, this is a key area of focus when we want to make positive changes. Lack of sleep can impact our mood, energy levels, and even our immune system. It can be helpful to create a calming nighttime routine which promotes relaxation and helps signal your body that it’s time to wind down. Limit the stimulation of screen time before bed, and try to maintain relatively consistent sleep and wake times (even on weekends), to regulate your body’s internal clock. Additionally, eating nourishing foods throughout the day and incorporating relaxation techniques such as meditation or deep breathing exercises can help calm the mind before sleep.

5. Engage in Joyful Movement

For many, the idea of exercising feels synonymous with punishment, and is connected with guilt and a desire to change our bodies. The ‘no pain, no gain’ mentality perpetuated by diet culture tells us that movement must involve burning calories or losing weight. Think about changing your focus to joyful movement - a celebration of what your body can do. Whether it’s dancing to your favorite song, going for a walk in nature, or trying a new sport, find activities which bring you joy. Pay attention to how your body feels during and after the activity, and let the positive experiences guide your choices.

Here’s to a non-diet New Year—one filled with kindness, self-compassion, and body freedom.

Mental Health Concerns and Eating Disorders During Perimenopause

What is Perimenopause?

Perimenopause is the life stage when a woman’s body transitions toward menopause (the end of her reproductive years, when the body no longer produces eggs). Perimenopause typically begins sometime in a woman’s 40’s, but there can be significant variance with some women noting changes in their 30’s, and some not until their 50’s.

The perimenopause period usually lasts between 5-10 years, and in Australia the average age for reaching menopause is 51 years.

Menopause is most often a natural life event, but it can also be triggered by gynaecological surgeries or the use of certain medications (including some treatments for cancer). Perimenopause can be experienced by all people assigned female at birth (AFAB) who sill have their ovaries, including trans-men.

Why is it important that we know about Perimenopause?

Perimenopause can bring a variety of physical and emotional changes which significantly impact on wellbeing and quality of life. These changes vary in severity from person to person, and across the perimenopausal period. There’s a lot that can be done to support women during perimenopause, and it’s important that everyone is aware of the symptoms associated with this time, considering how they can support women during the transition. Some of the compounding factors which can exacerbate the experience of perimenopause are isolation, misinformation, judgement, and a lack of care or support.

There are numerous mental health concerns which women transitioning through menopause may experience, along with increasing risk of cardiovascular disease and reduced bone density. Women at midlife also have significantly increased risks of mental health concerns such as depression and anxiety, and an increased risk for the development or re-occurrence of an eating disorder.

Common symptoms of Perimenopause

According to a 2023 study conducted by the Jean Hailes Foundation for Women’s Health, approximately 20% of women experience no symptoms of perimenopause at all. For those who do experience symptoms, these can be triggered by fluctuating hormone levels, which often coincide with major life changes and stressors associated with midlife. The range of symptoms which may be attributed to perimenopause can include, but are not limited to, those below.

Some possible physical symptoms of perimenopause:

• Irregular or missed periods, or changes in menstrual flow

• Changes in ovulation patterns

• Hot flushes and night sweats

• Sleep disturbance

• Fatigue and headaches

• Muscle and joint aches

• Vaginal dryness and breast tenderness

• Bladder weakness and more frequent urge to urinate

• Skin dryness and sensitivity

• Loss of libido or reduced sexual pleasure

• Altered digestive patterns and tolerance of foods

• Changes in body shape, size and composition

Some possible mental and emotional symptoms of perimenopause:

• Feeling anxious or irritable

• Low mood or mood swings

• Forgetfulness or ‘brain fog’, difficulty concentrating

• Difficulty coping with life events

• Challenges adjusting to your changing body

Perimenopause and Mental Health

The emotional challenges of perimenopause should not be underestimated. Hormonal fluctuations associated with this life phase are linked to an increased risk of anxiety and depression, even for those without a prior history of mental health issues.

Research has found an increase in suicidal thoughts for women at midlife, and completed suicide rates for women in Australia are highest in the perimenopause period.

Physical symptoms like night sweats, brain fog and fatigue can exacerbate mood disturbances. Additionally, perimenopause often coincides with major life changes such as retirement, family and relationship changes, increased caregiving responsibilities, and personal loss, which can all contribute to increased stress.

The changing relationship with the body during menopause can also present a significant change for many women. There may also be a period of adjustment as women come to terms with no longer experiencing monthly reproductive cycles, which can impact on identity and the experience of femininity.

Body size and shape changes during Perimenopause

Perimenopause often brings significant changes in body weight, shape and composition. While hormonal changes contribute to these shifts, other factors such as lifestyle changes also have an impact. Women transitioning through menopause may also notice changes in their appetite and digestive patterns. The aging process, which naturally decreases lean muscle tissue, can make it more challenging to maintain muscle mass and manage weight. Additionally, weight cycling, or repeated dieting, can lead to further muscle loss and fat gain over time.

All of these factors can add more stress for women in perimenopause, especially when faced with diet culture messaging about body ideals and fear of weight gain.

A balanced perspective on understanding and accepting the naturally occurring body changes, while also focusing on nutrition and activity levels for optimal wellbeing is important, particularly to avoid extreme or all-or-nothing responses to the changing body.

Eating Disorders and Perimenopause

Eating Disorders can be experienced by people of all ages and all genders. Traditionally thought of as conditions impacting young women, we now know that the rates of eating disorders being experienced by older women are increasing, and are a significant concern at midlife. These mid life eating disorders can be triggered by the changes of perimenopause, and may be either a first presentation at midlife, or a re-occurrence of a condition which had been experienced earlier in life.

According to the Butterfly Foundations ‘Paying the Price’ report (2024), almost one in four people experiencing an eating disorder in Australia each year are aged between 40-59. When sub-threshold eating concerns are included, 15% of perimenopausal women report at least some elements of disordered eating.

Major hormonal shifts experienced by women during perimenopause, like those experienced during puberty, pregnancy and postpartum periods, combine with pressures on women to meet cultural ideals of thinness and ‘anti-ageing’ to create a high risk period for the development of an eating disorder. Significant life events and stressors such as increased caregiving responsibilities or significant lifestyle changes can also trigger challenging eating behaviours and body image dissatisfaction in midlife.

Eating disorders during perimenopause are often overlooked by health professionals, who may not be aware of the prevalence of these conditions for women at midlife.

This is particularly notable when the full range of eating disorder presentations is considered, including Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Other Specified Feeding and Eating Disorders. Midlife eating disorders can have complex and serious health consequences, as the body is more vulnerable to complications such as digestive issues, osteoporosis, and dental problems, and fluctuating eating patterns can also exacerbate many of the symptoms of perimenopause.

“Drawing on a summary of evidence by Samuels, Maine & Tantillo (2019), factors which contribute to body dissatisfaction and eating disorder prevalence in midlife include:

• Stress and anxiety in relation to the physiological changes of ageing, which can contribute to feelings of loss of control in the context of a culture that valorises youthfulness

• The impact of weight suppression and disordered eating over many decades of life

• The lack of older women role models amidst ageist social norms which frame ageing as something to defy and combat with diet, exercise and medication regimes

• The ongoing impact of diet culture, where disordered eating is framed as normal behaviour from a young age

• High levels of body dissatisfaction among women aged 50 and over

• Experiences of shame, stigma and isolation, given that eating disorders are stereotyped as illnesses affecting young people, and health professionals may perceive older people as ‘too old to have an eating disorder’.”

(From The Butterfly Foundation: ‘Eating Disorders and Body Dissatisfaction During Menopause’.)

Seeking help during Perimenopause

The hormonal and life changes associated with perimenopause can be challenging, with the difficulties exacerbated for people who feel isolated and unsupported during this time. If you or someone you know is struggling with the symptoms of perimenopause, or may be experiencing body dissatisfaction or eating disorder symptoms during midlife, the team at Mind Body Well can offer support and guidance to help navigate this phase. We also recommend the links below for further information.

• Australasian Menopause Society

• Jean Hailes Foundation for Women’s Health

• Perimenopause Symptom Checker

• Eating Disorders Victoria free online course - Menopause and Eating Disorders

• Butterfly Foundation - ‘Paying the Price for Eating Disorders’

Our Director Janet Lowndes reflections after attending the Asia Pacific Conference on Women’s Mental Health in October, 2024. (General information only, please consult your health professionals for individualised medical or psychological advice).

Weight Stigma Awareness Week

Weight Stigma Awareness Week is an annual campaign aiming to eliminate weight bias and ‘end the resulting stigma, shame, trauma, and discrimination around body shape and size’. This post explores the impacts of weight stigma and what we can do to change it.

What is Weight Stigma?

Stigma occurs when an individual or group is viewed in a negative way or treated differently because of a particular characteristic they possess. Weight stigma refers to discrimination against people based on body weight and size. This stigma is a result of weight bias, which involves prejudicial attitudes and beliefs about people based on their their weight. Weight stigma and bias can show up in a multitude of ways, including:

• Stereotypical beliefs - e.g. making assumptions about a person based on body size and attributing certain personality traits / characteristics to people based solely on their weight

• Negative attitudes - e.g. a dislike of people because of their weight

• Discriminatory behaviours - e.g. social exclusion, bullying

Internalised weight stigma occurs when people hold negative and critical beliefs about their own body weight, which can happen regardless of actual body size. This is however more often experienced by people who have bodies larger than the cultural ‘ideal’.

Note – we’re using the word ‘fat’ throughout this post as a descriptor of a bodily characteristic. This neutral use of the term represents an acceptance of all body sizes, and is free from judgement.

Where does weight stigma come from and what does it look / sound like?

Like other biases that result in stigma (e.g. racism, homophobia, ableism etc), weight stigma is the result of conditioning from exposure to common negative messaging about weight and fatness which leads us to think about weight and larger bodies in unhelpful ways. People aren’t born with inherent weight bias; it’s learned, usually in families and communities from a young age. Weight stigma can be perpetuated in many areas, including:   

Healthcare settings

• ‘Diagnosis fat’, where a health practitioner attributes symptoms purely to a persons weight, often causing them to not investigate further, potentially missing underlying / other causes

• The ‘War on Obesity’, with a the push to categorise certain body weights / shapes as a disease, using BMI as a marker of individual health

• Health concern about behaviours exhibited by fat people, while thin people are given a pass for engaging in similar behaviours

• Under-recognition of the impact of genetics and broader environmental factors influencing weight and body size, and overemphasis of the role of individual behaviours and a perception of the ability to control body weight and size

In the media

• Fat bodies are often dehumanised in news stories, shown as ‘headless torsos’, or exhibiting stereotypical behaviours, e.g. eating certain foods

• In movies and books fat characters are rarely portrayed positively, often relegated to being the villain, the comedic relief, or with a storyline of their weight as a struggle to be overcome

• Social media algorithms promoting content of people with thinner bodies, and limiting the reach of fat content creators  

In public spaces

• Shops only stocking larger clothing sizes online rather than in store (or not supplying larger sizes at all)

• Seating which limits who can comfortably use it, e.g. airplanes, lecture theatres, cinemas, booths / tables with unmovable chairs

In workplaces & social settings

• Weight has been shown to influence hiring decisions and affect career progression / promotions

• Diet talk which often shows up in lunchrooms or at social events involving food, e.g. good / bad food talk, complimenting weight loss and talking negatively about weight gain

• Colleagues encouraging others to diet and offering unsolicited weight loss advice

In eating disorder treatment settings

• Outdated weight criteria built into diagnostic labels, e.g. continuing to differentiate between anorexia nervosa and ‘atypical’ anorexia nervosa, despite a growing body of evidence which shows there are few if any differences between these presentations (beyond body size)

• Perpetuating the fear of fatness by setting weight restoration targets too low, encouraging weight loss in higher weight people with eating disorders, or promising people that they wont gain weight in recovery

What’s the impact of weight stigma on individuals and communities?

While weight stigma can negatively impact the health and wellbeing of a range of individuals and communities, the impact is disproportionately felt by people in larger bodies. As with other forms of stigma, these negative impacts are typically the results of the accumulation of repeated common experiences of discrimination (micro-aggressions) rather than a single event.

The negative impacts of weight stigma can include:  

• Poorer mental health, e.g. changes to mood, development of mental illness, use of coping strategies which further impact mental health

• Impacts of prolonged exposure to stress and stress hormones on physical health 

• Isolation, both from social exclusion by others and fear / anticipation of rejection based on previous experiences impacting behaviour

• Delaying medical care due to concern about weight based discrimination experiences from healthcare providers, or having illness missed due to ‘diagnosis fat’

• Perpetuating dieting and disordered eating behaviours in an attempt to try and control weight which often leads to weight cycling and poorer physical health

With all this in mind it’s important to remember that we shouldn’t only care about weight stigma because it’s bad for people’s health – but because everyone, in all bodies - deserves to be treated with respect.

What can be done about Weight Stigma?

Like other forms of stigma a multifaceted approach is needed which includes advocating for structural change, e.g. legislating to protect people from weight-based discrimination, education campaigns to help challenge weight bias, identifying and eliminating weight bias in healthcare education settings etc.

Individuals can also act to address weight stigma by:

• Interrogating your own beliefs about weight, and understanding where these beliefs come from. This blog is just a starting point, we recommend taking a ‘deep dive’ into some of the resources listed below

• Pushing back against weight-based discrimination whenever you see or hear it (and not only when you’re around fat people)

• Ditching food and body talk and weight / appearance based compliments - there are many more interesting things to talk about than commenting on a persons appearance

• Requesting that public spaces are accessible for all bodies, and not leaving this up to fat people alone to advocate for this, e.g. cinema / airplane seating, chairs in waiting rooms, clothing accessibility

• Supporting and consuming media content produced by fat people, and content which includes positive representations of fatness

• Being an ally to people who experience weight based discrimination

Want to learn more?

Body Image and Eating Disorders Awareness Week 2024

September 2-8, 2024 is Body Image and Eating Disorders Awareness Week

Body Image and Eating Disorders Awareness Week (BIEDAW) is an annual health promotion campaign raising awareness about body image concerns and eating disorders. This year the focus is on communication - assisting people to consider the impact of what they say about bodies - both their own and others.

The following statements from The Butterfly Foundation provide some helpful alternatives to diet culture talk.

Head over to The Butterfly Foundation website to see more information and helpful resources including a very useful script to help you advocate for yourself when visiting health professionals, including Doctors.

Acknowledging NAIDOC Week

NAIDOC week (7th-14th July 2024) is a time to recognise and celebrate the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. This year’s theme is ‘Keep the Fire Burning! Blak, Loud and Proud’, which celebrates the resilience and vitality of Indigenous cultures, ‘inviting all Australians to listen, learn, and engage in meaningful dialogue, fostering a society where the wisdom and contributions of Indigenous peoples are fully valued and respected’.

As an eating disorder focused team, we at Mind Body Well are aware of the need for our professional community to recognise, understand and better respond to eating disorders occurring amongst First Nations people. To date there has been a significant lack of research into the presentation, assessment, and treatment of First Nations peoples’ mental health, including eating disorders. The limited available research indicates the following:

• Eating disorders are prevalent at similar or higher rates among First Nations people compared to non-Indigenous Australians (1,2)

• One study showed that 30 per cent of Indigenous adults met the criteria for an eating disorder, compared to 18 per cent of non-Indigenous adults (1)

• Other Specified or Unspecified Feeding or Eating Disorders have been the most prevalent among First Nations people, often including behaviours around binge eating or night eating (1,2), and purging behaviours can be twice as likely in Indigenous youth

• Approximately three in ten Aboriginal and Torres Strait Islander young people are extremely or very concerned about their body image, and First Nations peoples have reported higher levels of weight/shape overevaluation (1,3)

• Eating Disorders in First Nations people have been associated with lower levels of overall mental health related quality of life (1) and poorer psychosocial quality of life (4)

• There are currently no culturally appropriate eating disorder screening and assessment tools which have been validated for Aboriginal and Torres Strait Islander Peoples

• First Nations people experience multiple risk factors and vulnerabilities which can increase the likelihood of developing an eating disorder, such as intergenerational trauma, food scarcity, discrimination, minority stress and systemic racism

The eating disorder field urgently needs culturally safe eating disorder research and targeted treatment options for Indigenous Australians. Eurocentric model of mental health care have traditionally focused on symptom resolution, often at the expense of holistic wellbeing and harm reduction strategies. Understanding and working to dismantle intersectional oppression is core to providing inclusive eating disorder care and body liberation for all people.

While acknowledging the harms and oppression experienced by First Nations people, we also celebrate the resilience and strength of the world’s oldest continuous living culture.

We’ve listed some supports for First Nations people below:

• 13 YARN: Phone counselling provided by Aboriginal and Torres Strait Islander Crisis Supporters

• Gayaa Dhuwi (Proud Spirit) Australia: National Aboriginal and Torres Strait Islander social and emotional wellbeing, mental health and suicide prevention leadership body

• National Aboriginal Community Controlled Health Organisation (NACCHO): national leadership body that provides advice and guidance to the Australian Government and advocates for community-developed health solutions that contribute to the quality of life and improved health outcomes for Aboriginal and Torres Strait Islander people.

References

1. Burt, Adam et al (2020) ‘Prevalence of DSM-5 Diagnostic Threshold Eating Disorders and Features amongst Aboriginal and Torres Strait Islander Peoples (First Australians)’. BMC Psychiatry, 20(1)

2. Burt, Adam et al (2020) ‘Eating Disorders amongst Aboriginal and Torres Strait Islander Australians: A Scoping Review’. Journal of Eating Disorders, 8(1)

3. McCabe MP, Ricciardelli L, Mellor D, Ball K. (2005) ‘Media influences on body image and disordered eating among indigenous adolescent Australians’. Adolescence, 40(157)

4. Burt, Adam et al (2020) ‘Prevalence, Features and Health Impacts of Eating Disorders amongst First-Australian Yiramarang (Adolescents) and in Comparison with Other Australian Adolescents’. Journal of Eating Disorders, 8(1)

International Day Against Homophobia, Biphobia, Interphobia and Transphobia

The International Day Against Homophobia, Biphobia, Interphobia, and Transphobia (IDAHOBIT) is celebrated on May 17th each year. BegiNning in 1990, the date was chosen to mark the removal of homosexuality as a disorder from the World Health Organisations ‘Classification of diseases and related problems’.

According to the IDAHOBIT website, the day has two main purposes:

1. To celebrate the pride and allyship of the people who work to build equality around the world, and

2. To raise awareness of the discrimination LGBTQIA+ people continue to face today

LGBTIQA+ people experience higher rates of mental health challenges than the general population. The Private Lives 3 report found a greater prevalence of psychological distress, anxiety, and depression among all groups within the Australian LGBTIQA+ community, with transgender and bisexual+ people particularly at risk.

What causes this higher prevalence of psychological distress?

LGBTIQA+ people are more likely to experience prejudice and discrimination than the general population. Over time repeated exposure to negative attitudes and distressing situations can start to affect the physical and mental health of minority groups – a process known as minority stress. Minority stress can make it harder to engage in health promoting behaviours and can lead to increased drinking, drug use, and attempts to control eating or body weight/shape as coping strategies.

A growing body of research points to higher rates of disordered eating and eating disorders among the LGBTIQA+ community, particularly trans and gender diverse people. While there are many common eating disorder risk factors minority stress certainly plays a part as well as the pressure that some LGBTIQA+ people feel to fit in with rigid body standards and gender norms to feel accepted and avoid discrimination. 

Discrimination can sometimes occur when people are attempting to access healthcare services, and this can lead to LGBTIQA+ people being reluctant about reaching out for help. At Mind Body Well we are committed to providing safe and accessible healthcare to people from LGBTIQA+ communities.

We also recommend the following services for LGBTIQA+ Victorians seeking additional support for mental health concerns:

• QLife - provides free daily peer support from trained members of the LGBTIQA+ community Australia wide via anonymous phone and webchat

• Rainbow Door - a free helpline providing information, support, and referrals for LGBTIQA+ Victorians

• Eating Disorders Victoria BLOOM support group - BLOOM is a fortnightly group run by Eating Disorders Victoria for LGBTIQA+ people with eating disorders

More information about IDAHOBIT can be found on the IDAHOBIT website.

Rethinking Diet Culture and Embracing International No-Diet Day

May 6th marks International No-Diet Day (INDD) – an important occasion to reflect on the potential harms caused by weight loss dieting. Initiated by feminist groups in the UK in 1992 under the leadership of Mary Evans Young, INDD provides an opportunity for a number of important reflections:

• Challenge cultural ideals: INDD encourages us to challenge societal norms surrounding body shape and size

• Raise awareness: Shedding light on weight discrimination and fat phobia, advocating for greater acceptance and inclusivity

• Combatting diet culture: iNDD prompts us to question the industries profiting from body dissatisfaction and dieting norms

• Prioritising body liberation: The day emphasis the importance of freedom and liberation from societal beauty standards

As we acknowledge INDD this year, we’re reflecting on the bigger picture - the context in which diet culture (the pervasiveness of dieting norms and the perceived value of weight loss dieting) manifests in our communities. Weight loss dieting, often considered a solution for many grappling with body image issues, actually poses significant risks and harms, including:

• Eating Disorders: Weight loss dieting is a significant risk factor for the development of an eating disorder

• Health Issues: It can compromise nutritional adequacy and lead to multiple adverse health effects

• Social Isolation: Dieting can be isolating, causing people to exclude themselves or withdraw from social occasions which involve food

• Mental Health: Weight loss dieting exacerbates body dissatisfaction and distress, which has a cause-and-effect relationship with poor mental health outcomes such as depression and anxiety

• Mind-Body Disconnection: Weight loss dieting teaches us to be at war with and to disconnect from our bodies - which has multiple adverse physical and psychological implications

• Perpetuating Stigma: Weight loss dieting perpetuates weight stigma and weight bias

• Financial Costs: Additionally, weight loss dieting incurs significant financial expenses *

It is essential though to acknowledge that many people turn to dieting as a means of regaining control in a world inundated with conflicting messages about nutrition and body image. Simply advising people to ‘stop dieting’ isn't enough; they need viable alternatives. Dr. Rick Kausman's question, ‘If Not Dieting, Then What?’ (also the title of his 2004 book) prompts us to explore alternatives which prioritise wellbeing over weight loss and recognise and respect the diversity of body types.

Zooming out to the societal level, it becomes evident that diet culture thrives within a context of weight stigma, bias, and weight normativity.

• Weight bias – negative assumptions and judgements about people in larger bodies

• Weight stigma – social devaluation and discrimination based on weight and shape

• Weight-normativity - emphasises weight and weight loss as central to defining health and wellbeing (ie. Assumes health based on weight)

• Weight-inclusivity – emphasises health and wellbeing as multifaceted and related to many aspects of a persons life (ie. Recognises social, emotional, physical and spiritual aspects, the importance of the whole person and the context in which they live)

It’s not enough to merely recommend to someone that they stop dieting… when we live in a weight-normative culture which tells us that thinner is better, and that we’re ‘wrong’ for existing in bodies which are anything other than the cultural ideal. Assumptions about weight and size need to be continually challenged and addressed, recognising that for many people, weight loss dieting makes sense as a response to the culture they exist within. It’s not enough to put the pressure on someone to change – it’s the culture that needs to change, to make it safe for people to exist in a diverse range of bodies, and to be valued and treated with respect without any expectation of a need to shrink their body in order to be OK.

Zooming in again to the individual level, we offer the following suggestions for potential alternatives to weight loss dieting. These are just suggestions… think about what works for you, and how you can ‘opt-out’ of diet culture… even if just for today:

• Focus on taking care of your body, nourishing and nurturing it in ways that feel good for you. Go for a walk in nature, lay under a tree, have a long bath…

• Explore your relationship with food, try to understand all the different motivations you have for eating, and bring self-compassionate awareness to those motivations

• Eat for both pleasure and nourishment – consider the importance of nourishing yourself both physically and emotionally in many different ways

• Celebrate and enjoy a wide range and variety of foods – allow yourself to really dive into the sensory pleasure which comes from fully experiencing food

• Spend time with people who value and recognise you for who you are, seek out communities in which you feel safe

• Expose yourself to diverse messages about bodies – do a social media audit and be ready to unfollow any accounts which perpetuate the ‘thin is best’ ideal, especially those which suggest there is any right’or wrong way of eating

• If this is a particularly tricky issue for you seek out a Psychologist, Dietitian, or other health professional who can assist you to untangle and address the ways weight stigma and weight bias effects you, and who can help you explore alternatives to diet culture

Importantly… recognise messages of weight bias and stigma in your environment, and chose not to perpetuate them. If you have the energy to challenge these messages, then by all means do so - be a social justice campaigner and advocate for respect and inclusion for all people, regardless of the characteristics of their body.

All bodies are worthy of care and respect.

(* The global weight loss and weight management market value in 2021 was USD $224 billion USD, and by 2030 is predicted to be $405 billion USD (Source – Global News Wire February 9, 2023). This ‘market value’ is being paid for by the people who are driven by body dissatisfaction and distress to purchase products and methods they’re sold under the guise they will make them thinner, and happier. And this is just referring to the direct costs associated with dieting. It’s impossible to put a price on the costs of poor nutrition caused by restrictive eating, eating disorders triggered or exacerbated by the pursuit of thinness and body dissatisfaction which the diet industry profits from, and other mental health challenges exacerbated by weight stigma and weight bias.)

Related past articles:

• Wellness program or diet in disguise?

• What does it mean to be a ‘Non-Diet Dietitian’?

• Breaking up with weight loss

• What is Intuitive Eating?

• About mindful eating

• What is the ‘non-diet approach’?

• Love your body

Navigating Diet Culture During Easter

While Easter is often viewed as a time to get together with loved ones and celebrate by sharing food, it can also be a challenging time for people with lived and living experience of an eating disorder, and/or those who are actively working to challenge the impact of diet culture on their lives. Similar to Christmas or any other holiday period, it may feel difficult to navigate Easter for the following reasons:

• Traditional or common Easter foods (e.g. chocolate, hot cross buns) may be feared foods, or foods associated with dietary rules

• Due to the short-term availability of these foods, there can be a sense of ‘last supper’ eating, as they will only be accessible for a limited period of time

• There’s an increase in diet talk, often including comments around ‘indulging’ and being ‘naughty’ or feeling guilty for eating particular foods

• Changes in routine due to the long weekend, and other activities such as seeing family or being away from home

• Reduced or different availability of usual support systems

All of these factors can increase the risk of engaging with challenging eating behaviours such as food restriction, bingeing and/or compensating behaviours, as well as experiencing higher levels of distress or preoccupation around food or body image. The following suggestions may assist in navigating the Easter period:

• If you’re in eating disorder treatment, make a plan with your treatment team, e.g. whether you want a more structured and purposeful approach, or whether you are feeling ready to approach it more spontaneously

• Continue eating regularly, and maintain some structure around consistent food intake even amidst different routines and activities

• Remember this is just another day (or few days), and any increased pressure associated with this time will pass

• If you’re struggling with ‘last supper’ eating, practice allowing yourself these foods now, and remember you can enjoy them again next year. It might also be helpful to find equivalents, e.g. different types of chocolate or fruit buns which are available the whole year

• Refocus on your values by connecting to what feels important to you around this holiday, e.g. connection, rest, adventure, family, spirituality, creativity etc

• Be curious as to whether this period presents an opportunity to challenge some of your existing food rules and beliefs

• Plan ahead where you can, enabling you to manage your expectations and prepare for some of the challenges you may face. Having some of your ‘safer’ foods available may assist in maintaining regaular eating

• Talk to your loved ones ahead of time, let them know about any particular concerns you have, and brainstorm some of the ways they can support you

If you are in eating disorder recovery and you’re working on food challenges, try the following suggestions:

• Build up your challenges in a graded manner to give yourself the best chance of success, e.g. start with smaller or individually wrapped chocolates and build up to larger portions

• Explore your beliefs both before and after eating, e.g. ‘what am I afraid of / what do I think will happen as a result of eating this food / how strongly do I believe this thought?’. Try to access your recovery mindset in challenging these thoughts

• Remember that all foods are neutral, and labelling foods as good/bad only gives the foods and our fear or avoidance of them more power

• Push back on diet culture by putting these thoughts where they belong, e.g. rather than thinking ‘I’m bad for eating an Easter egg’, reframe it to recognise ‘This is diet culture talking’. Remember that the eating isn’t the problem, but diet culture is

• Plan strategies or supports which can help you challenge yourself, e.g. sharing Easter baking with a friend, or planning a distraction afterwards to reduce rumination

• Remember that compensatory behaviours undo the hard work you put into challenging a food rule, and to get the most out of challenging yourself it’s important not to dilute the challenge by engaging in eating disorder behaviours before or after eating

• Practice self-compassion - remember it’s okay if challenges feel harder than expected, allow the emotions to be present and explore self-awareness and self-kindness. Try to remember the helpful strategies you have in your toolkit to manage any tricky situations that arise, and set aside some time for yourself to engage in self-care activities that allow you to feel safe, grounded and calm.

Remember, celebrations such as Easter are about much more than food. This may be an opportunity to get together with loved ones, or it may be a time for rest and relaxation. Focus your attention on things that have meaning for you, and create some wonderful Easter traditions of your own.

The relationship between Endometriosis, eating concerns, and body image

While there has been some attention in the field of women’s (and AFAB folk) reproductive health to the psychological impact of conditions like Polycystic Ovary Syndrome (PCOS), awareness is now also growing around the mental health aspects of Endometriosis - particularly its influence on body image and eating concerns.

Endometriosis is a reproductive health condition in which tissue similar to the lining of the uterus grows outside of it, often causing inflammation, chronic pain, and other distressing symptoms such as bloating and digestive discomfort. These symptoms can create a sense of disconnection from the body, making everyday activities challenging. Coping with chronic pain, unpredictable digestion, and ongoing discomfort can significantly affect how people perceive and relate to their bodies, sometimes leading to attempts to regain control through food and eating behaviours.

The Psychological Impact of Endometriosis

Research has highlighted the toll that Endometriosis can take on self-esteem and body image. Some people describe feeling ‘broken’ or ‘inadequate’, or struggling with the sense that their body is outside their control. These experiences can create vulnerability to negative self-perception and self-criticism, reinforcing distressing emotional cycles.

There is no shortage of dietary advice aimed at managing Endometriosis symptoms. Unfortunately, much of this information lacks scientific backing and promotes restrictive eating patterns, which can increase body dissatisfaction and heighten preoccupation with food. Compounded by societal pressures around body image, exercise, and diet, people may feel further disconnected from their bodies - potentially navigating hormonal therapies, recurrent surgeries, fertility concerns, and challenges with sexual arousal and intimacy, and pain during intercourse.

A 2021 study explored why some people with Endometriosis experience higher levels of emotional distress. The findings pointed to negative body image and self-criticism as key contributors to psychological distress. One participant described it as “a vicious cycle of feeling like my body is constantly falling short,” which led to increased feelings of failure and self-blame.

We also know that fostering self-compassion, improving body acceptance, and developing emotional coping strategies can enhance mental well-being for those with Endometriosis. Building a supportive relationship with your body is important to manage the psychological aspects of chronic health conditions.

Endometriosis and Eating Concerns

Although research on the relationship between Endometriosis and Eating Disorders is limited, studies indicate that people with Endometriosis frequently alter their diets in an effort to manage pain and gastrointestinal issues.

Clinicians working with people who have Endometriosis often observe a desire to control food intake as a means of managing bodily discomfort, which can complicate a persons relationship with eating and body image. When dietary changes become overly rigid or restrictive, they may lead to disordered eating patterns or heightened distress around food.

What Can Help?

1. Prioritise a Healthy Relationship with Food and Body Image – While dietary modifications may help manage symptoms, it’s essential to focus on overall well-being rather than rigid food rules. Aim for balance and flexibility in eating rather than control or restriction

2. Seek Support from Knowledgeable Health Professionals – If considering dietary changes, consult a qualified Dietitian who understands both Endometriosis and eating concerns. Additionally, mental health professionals can help navigate the emotional impact of chronic illness

3. Emphasise Body Acceptance – Developing a more accepting relationship with your body can significantly improve well-being. Rather than focusing on perceived flaws, prioritise self-care and compassion for your body, and gratitude for it’s strengths and abilities

4. Cultivate Self-Compassion – Managing a chronic health condition is complex. Practising self-kindness rather than self-criticism can shift how you relate to your body. Working with a Psychologist can help develop strategies for fostering self-compassion and emotional resilience

How Mind Body Well Can Help

At Mind Body Well, our therapists understand the complex relationship between chronic illness, body image, and eating concerns. We provide client centered, evidence-based support to help people navigate the emotional and psychological challenges of living with Endometriosis. Our team of Psychologists and Dietitians are experienced in supporting people with reproductive health concerns.

Navigating Social Media to Promote Positive Body Image

In our digitally driven world, social media has become an integral part of our daily lives. From connecting with friends to staying updated on the latest news, it's a tool which has immense influence on our lives. Alongside the convenience and benefits, social media also presents a number of challenges, particularly in relation to body image.

The prevalence of unrealistic beauty standards portrayed on social media can have a big impact on how we perceive ourselves. Repeated exposure to these perfected images can cause us to feel inadequate, and may contribute to body dissatisfaction.

Social media can also be a great tool to assist in promoting positive body image, fostering self-acceptance and encouraging inclusivity. The key factor is how we choose to engage with social media. Here are some tips on how to use social media in a way which promotes positive body image and can protects us from dissatisfaction or potentially disordered eating behaviours.

1. Check in with Your Feelings

Notice how you feel during and after being on social media. If certain pages, accounts or images leave you feeling negative about yourself or trigger comparison, consider whether following them is beneficial to your well-being. Your mental health should always be the priority.

2. Curate Your Feed

Follow accounts and people who promote body diversity and inclusivity, and unfollow those which perpetuate harmful beauty standards. Exposure to a broad variety of body types, shapes, ages, genders, and ethnicities can reshape your perception and foster inclusivity.

3. Remember: It's Not Reality

Keep in mind that what you see on social media is often a curated portrayal of someone's life… the highlights reel. Remember also that images may be edited, filtered or enhanced, so what you’re seeing may be not be real. Remind yourself of this when comparing your life to others. Share authentic moments from your own life to contribute to a more genuine online community.

4. Combat Comparison

As the saying goes, ‘Comparison is the thief of joy’, and this is especially so on social media. Remember that you’re comparing yourself to the best possible version of another persons life, and if you begin to slip into critical self-talk, it’s probably time to move away from social media for a while to do something which focuses on your own life, your own opportunities and achievements.

5. Prioritise Health and Well-being

Move your focus away from appearance, to instead pay attention to your overall health and well-being (which is much broader than just the things we’re able to photograph and share on the socials). Embrace discussions about what makes you feel good physically, mentally, and emotionally.

Social media can either perpetuate harmful beauty standards or serve as a platform for promoting positive body image and inclusivity. By curating our feeds, being aware of our emotional responses, and fostering empowering content, we can contribute to a healthier and more accepting online community.

Ramadan and Eating Disorders

What is Ramadan?

Ramadan is a holy month of significance for Muslims. It is a period of 29-30 days where Muslims are challenged to increase in all forms of worship, revive their awareness of God and in turn, achieve a deeper connection. An integral expression of this is demonstrated through spiritual fasting (sawm).

Spiritual fasting involves abstaining from eating or drinking from dawn until sunset. The intention behind spiritual fasting distinguishes the act from other forms of fasting which may be intended for weight control or influencing metabolism.

For Muslims, fasting in Ramadan is a shared experience and therefore increases community connection. It is obligatory on all those who are capable (physically, financially, mentally etc) and of mature age (passed age of puberty). There are many conditions and circumstances, however, that exempt followers from needing to fast, especially if it poses a significant threat to a person’s health and well-being.

Every year, there will be millions of Muslims around the world who are unable to or struggle to fast due to their situation (including an active eating disorder). There are concessions that exist and can be verified by local religious leaders (e.g. an Imam). Nevertheless, the nature of an eating disorder is inherently encouraging of fasting and restriction and an eating disorder gaining control can be seamlessly disguised as religious practice. This can make seeking help extremely difficult and lead to feelings of shame, dismay and isolation.

Things to consider around Ramadan and eating disorder recovery

Eating disorders exist in all community groups and Ramadan can be a challenging time for Muslims who have an active eating disorder, or a lived experience of one.

A daily cycle exists of waking up early to eat, fasting during daylight, followed by breaking the fast at sunset. For a person who is unwell with an eating disorder, this cycle can trigger eating disorder thoughts and can even be contrary to their prescribed treatment. If this is the experience for you or someone you know, it is important to consider the following:

• You are not alone

• Speak to your GP about accessing professional support if you’ve not yet done so

• It is recommended to discuss your concerns with your treatment team and religious leader (e.g. an Imam) ahead of time in order to plan for Ramadan

• You may be able to decide on an adapted fasting schedule according to your needs and progress in recovery (e.g. fasting alternate days or fasting on shorter days of the year)

• Reflect on your intention behind fasting – are you fasting to express your religious beliefs or are you intending weight loss? Are you finding it impossible to eat sufficiently before dawn? Are you feeling this urge to delay breaking fast at sunset?

• If there is a supportive person in your family or community that you can talk to, it can be helpful to do so. There can be a lot of focus and conversation around food during Ramadan which is anxiety-provoking and having someone to turn may help you navigate that.

• It may be that you are not medically safe to participate in fasting at your current stage of recovery and that’s OK. Focusing on recovery today can mean that you can observe Ramadan more fully in the future.

Even if you are currently unable to fast, you can choose to explore the many other ways of practicing your faith that are also encouraged in Ramadan.

Other ways to participate in Ramadan

• Prayer and practicing mindfulness

• Donating time/clothes/food/money to people in need

• Preparing meals for others

• Attending Friday or night prayers at the local Mosque

• Appreciating that seeking treatment, taking steps towards recovery is honourable and an act of worship itself

Eid celebrations

As with Ramadan, Eid can be wonderful celebration with family and friends for millions of people worldwide. However, for people with an eating disorder, it can be a challenging time. They may even dread the day.

Festivities like Eid, will almost always involve special food in abundance and cultural traditions which can be triggering. In the lead up to Eid, it’s important that you express any fears you have with your support network (e.g. your treatment team, partner or family member). This can help you feel prepared and provide a sense of safety.

Journaling is a great way to put words to some of the emotions we feel and a useful release in addition to voicing our concerns with others. We can also use a journal to plan ahead for the festive day which could involve setting reminders to eat regular meals and snacks, scheduling time to check-in with ourselves and rest.

If there are some aspects of Eid that are more confronting for you (e.g. menu planning/cooking), then you might like to involve yourself with other aspects instead (e.g. decorating your home or organising gifts).

We can accept that some level of anxiety is to be expected and that it’s okay to have these feelings. Remind yourself that, like any other day, the day will pass. Try your best to be kind to yourself.

Blog post written by Aneela Panhwar, Former Accredited Practising Dietitian at Mind Body Well

Navigating 'Pride' when you have Body Image Concerns

Each year LGBTIQA+ pride events happen around Australia, typically coinciding with warmer weather and sunshine in the southern states, and dry season up north. Depending on where you live, your closest event might vary from a small march or fair day, through to a multi-week festival of LGBTIQA+ arts, culture, and parties.

The first Australian Pride march happened in Sydney in 1978 on the anniversary of the New York Stonewall riots. It was organised to promote gay and lesbian rights and to push back the against widespread discrimination and prejudicial laws of the time (homosexuality was still illegal). The first march was met with police resistance resulting in widespread arrests, but has continued each year since then with increasing support and acceptance. Over time the vibe has shifted from resistance to one of celebration.    

Pride and Body Image 

Despite the air of celebration at Pride events, not all LGBTIQA+ people feel comfortable attending. The Butterfly Foundation #BodyPride survey found that:  

• Over half (54%) of LGBTIQA+ people believe there are expectations to look a certain way within LGBTIQA+ communities 

• Nearly half (47%) of LGBTIQA+ people experience body image pressures in the lead up to Pride events like Mardi Gras 

• Over a third (36%) of LGBTIQA+ people engaging in dieting or disordered eating behaviours in the lead up to Pride events like Mardi Gras 

• You can read more about the survey and their #BodyPride campaign HERE

These findings are likely to be related to the impacts of minority stress, and pressure to conform to broader heteronormative gender and body norms. Minority stress results from exposure to anti-LGBTIQA+ prejudice and discrimination. This can create internalised shame within LGBTIQA+ people about their gender, sexuality, or differences in sex characteristics and increase sensitivity to rejection. Attempts to change ones body weight or shape might be used to gain external validation from others to try to overcome feelings of shame and increase feelings of acceptance/reduce rejection in LGBTIQA+ communities after coming out. Disordered eating behaviours are also sometimes used as tools to regulate emotional distress.  

Navigating Pride Events if you’re Experiencing an ED or Body Image Concerns 

Pride is a subjective experience and there is no right way to celebrate it. Choosing not to participate in marches or events doesn’t automatically make you less proud than anyone else. If you’re someone who wants to get involved but negative body image is getting in the way, then consider these suggestions: 

• Consult the program to find events that de-emphasise bodies or are explicitly inclusive and fat/body positive, e.g. queer history talks/tours, family friendly fair days, panel discussions about aspects of identity, bear parties 

• Try a social media cleanse – mute or unfollow any accounts that make you feel worse about your body or yourself and moderate engagement with photos of people added to Pride event hashtags  

• Wear something you feel comfortable in - clothes that constantly pinch, grab, or bunch up can keep your attention on your body and stop you from being present and enjoying the moment 

• Gather supports – if you have supportive friends, family, or partner(s) create a plan together for what to do it you start to feel anxious, overwhelmed, or shamed

• While dieting behaviours can sometimes provide short term relief from body/weight concerns, dieting ultimately leads to increased preoccupation with food and body, and potentially feeling out of control when eating. Focus on self-care in the lead up to events by eating foods you feel comfortable with regularly rather than restricting, particularly if you plan on drinking alcohol or using drugs 

• Embrace the rebellious spirit of Australia’s first Pride march and reject heteronormative body ideals. Showing up as your authentic self is an act of resistance in the face of an unjust rigid body and gender norms.    

If your relationship with your body or food is getting in the way of you living your best life reach out for support.  

The Importance of Professional Supervision for Dietitians

Professional supervision has long been recognised as an integral part of practice for psychologists and other mental health clinicians. Outside of student placements and perhaps some within workplace arrangements, supervision is likely to be less familiar to Dietitians (where a culture of mentoring is more common). This is however changing, thanks to the work of Dietitians Supervision Resources Australia, and the mandatory supervision requirements for maintaining Credentialed Eating Disorder Clinician (CEDC) status with the Australia and New Zealand Academy for Eating Disorders. This blog post will help to clarify what professional supervision is, how it differs from mentoring, and explain why it’s important for Dietitians to include supervision in their professional development plan.

Supervision vs mentoring – what’s the difference? 

Dietitians undertake mandatory mentoring (for 1 year) as part of the provisional Accredited Practicing Dietitian (APD) program. The goal of the mentoring program is to build the mentees knowledge and help brainstorm ideas and find solutions to career challenges. This may provide some crossover with aspects of supervision (e.g. facilitating reflective practice) but Dietitians Australia makes a clear distinction between the two. Once the mentoring program is complete there’s no ongoing requirement for mentoring to maintain APD status, but Dietitians are encouraged to seek out mentoring needed. Mentoring in this capacity may be ad hoc or a longer-term relationship, and there are no requirements for becoming a mentor.  

What is supervision? 

Hawkins & Shohet provide the following definition of supervision in ‘Supervision and the helping professionals’ (2012): 

“Supervision is a joint endeavour in which the practitioner with the help of a supervisor, attends to their clients, themselves as part of their client practitioner relationships, and the wider systemic context, and by doing so improves the quality of their work, transforms their client relationships, continuously develops themselves, their practice and the wider profession”.

Effective supervision is: 

• a structured and formal process with a clear purpose of developing the learning and growth of the supervisee  

• outlined by clear boundaries agreed upon by the supervisor and supervisee 

• dedicated to facilitating reflective practice of the supervisee rather than just providing answers to questions (although there is space for teaching too when needed) 

• built around providing learning, support, and accountability for the supervisee 

• a relationship that helps to improve Dietitians competence & wellbeing, improve career longevity, ensure that patients/clients of the supervisee receive high quality and safe care, and that dietetic practice aligns with the professional code of conduct      

• a skill that requires the supervisor to undertake training and an ongoing commitment to their own growth and development as a supervisor e.g. supervision of their supervision practice  

Dietetic supervision at Mind Body Well

Mind Body Well Dietitian Team Leader Tom Scully provides professional supervision (via Telehealth), which is particularly suitable for Dietitians who:

• have an interest in, or are already working with people with body image and weight concerns or a history of dieting 

• are interested in improving their confidence and competence in working with eating disorders or other areas of mental health including mood disorders and substance use disorder  

• are a Dietitian working within a minoritised community/group that you are a member of and would like a place to discuss the rewards and challenges that this can pose 

• work with LGBTIQA+ clients and would like to increase your confidence in providing culturally appropriate and affirming care 

You can read more about supervision at Mind Body Well and make an enquiry via the link below.

Enjoying Carbohydrates and Debunking Diet Myths

In a world so strongly influenced by diet culture, carbohydrates are often labelled as something to be feared, with popular diet regimes like Paleo and Keto advocating for their restriction or avoidance. This demonisation of carbs fuels the belief that our worth is dependant on our dietary choices, and that certain foods or entire groups of foods are ‘bad’, and a judgement is attached to us consuming them.

Let’s debunk some of these diet myths, and remember that all foods serve a purpose in nourishing our bodies.

The Importance of Carbohydrates: Carbohydrates are a fundamental food group which serve as a primary source of energy. Carbs are the food group which breaks down most quickly in our bodies, providing a great source of ready energy. Athletes for example often rely on carbs for a quick energy boost before training or competitions.

Brain Health and Mood Stability: Carbohydrates play an important role in supporting our brain health, being its preferred source of energy. Without regular carbohydrate intake, you may notice fluctuations in mood, increased irritability, and difficulty concentrating. Including carbs in your diet can help maintain stable blood sugar levels, preventing fatigue and cravings.

Stable Blood Sugar for Overall Well-being: Regular carbohydrate consumption contributes to stable blood sugar levels throughout the day. This stability can help reduce cravings and prevent the feelings of tiredness and fatigue often associated with erratic blood sugar levels.

Breaking Free from Food Restriction: Avoiding any food groups can lead to all-or-nothing relationships with food - the more we restrict something, the more we crave it, and the more likely we are to find it difficult to pay attention to our hunger-fullness signals when eating. Incorporating carbohydrates into your regular diet can help alleviate cravings and foster a healthier relationship with food.

Balanced Meals for Satisfaction: A well-rounded approach to nutrition involves a mix of carbohydrates, proteins, and fats. This balance not only satisfies your hunger but also provides the necessary nutrients for sustained energy throughout the day.

Gut Health and Variety: Carbohydrates also contribute to gut health by providing essential fibre. A diet rich in fibre supports the growth of beneficial gut bacteria and helps prevent issues like constipation. Experimenting with different types of carbs adds variety to your meals, making the eating experience more enjoyable and diverse.

The Pleasure of Carbs: Let’s face it, carbohydrates are delicious. There’s a carb to suit everyone - bread, biscuits, rice, pasta, cake, fruit, yoghurt, sweet potato, chips, lollies, legumes, lentils… the list of delicious choices goes on an on.

Rather than succumbing to external food rules, it’s important to listen to your body's needs, embrace variety, and nourish yourself with a wide variety of foods, including carbs. If you’d like to learn more about your bodies nutritional needs, our team of non-diet Dietitians at Mind Body Well can help.

Wishing you a Non-Diet New Year

As the year draws to a close we’re encouraged to reflect on the past, and to contemplate changes we'd like to make for the year ahead. This time of year is ‘peak-season’ for the diet industry, and we’re exposed to a plethora of messages telling us that the problems in our lives can be solved through weight loss – which is of course a very long way from the truth.

This year we encourage you to break free from diet culture, and to focus on positive and sustainable goals which can contribute to positive well-being. Here are some strategies to consider:

1. Unplug from Negative Influences

Social media has become an integral part of our lives, but its impact on mental well-being is often underestimated. Take a close look at your social media accounts and unfollow any content which triggers negative thoughts or feelings about your body or lifestyle. Instead, curate your feed with accounts that inspire and uplift you, fostering a positive online environment. More puppies and kittens, less wellness influencers!

2. Break Free from Food Rules

‘Food rules’ are beliefs or vales which can dictate when, how, and what we eat. Challenge these rules to embrace a more intuitive approach to eating, paying attention to what you really want to eat (as opposed to what you think you ‘should’ have). Remember that food is not inherently good or bad; it's a source of nourishment and enjoyment. Shift your mindset by using neutral and non-judgemental terms to describe the food you consume.

3. Cultivate Self-Compassion

While we may be adept at showing kindness to others, extending the same compassion to ourselves can be challenging. Building self-compassion is an important step toward fostering resilience and self-care. Even if your thoughts are not yet self-compassionate, take actionable steps to be kind to yourself. Schedule self-care and self-nurturing activities in the day, week and year ahead.

4. Prioritise Quality Sleep

Our sleep patterns impact so many aspects of our lives and have a powerful influence on our physical and mental health and wellbeing. Establishing a good night-time routine can significantly assist your sleep patterns. Create a conducive sleep environment by limiting screen time before bed, maintaining consistent sleep and wake times, eating nourishing foods across the day, and engaging in relaxation or meditation strategies.

5. Engage in Joyful Movement

If incorporating more movement into your routine is a goal, focus on activities you genuinely enjoy. Instead of seeing exercise as a chore or punishment, see it as a celebration of what your body can do. Think about physical activities you’ve enjoyed at different times in your life, and explore all kinds of different forms of movement. Pay attention to how each activity makes your body feel, and let joy be your guide.

Happy New Year, from the team at Mind Body Well

Navigating Diet Talk and Body Image Concerns During the Holiday Season

The holiday season is a time for celebration and relaxation. It's a time to gather with people we care about, and hopefully also a time for some rest. However this can also be a time when diet culture ramps up, creating pressure in the warmer weather to focus on our ‘bikini body’, attending events which are usually centered around food and eating, and the impending wellness focus of New Year's resolutions – all of which can make the holiday period a minefield of diet talk and body image distress.

In this article, we'll explore strategies to help you navigate the challenges of diet talk and body image concerns during the holidays. Different factors such as your environment, relationships, personal history, and comfort levels can influence which strategies are most effective for you – so think about how you can personalise this information for your own circumstances.

Setting Boundaries

Where possible it can be helpful to set some boundaries prior to an event. Depending on your relationship with the people involved and your comfort level, it might be possible to let people know how they can support you – maybe you could communicate these boundaries in person or via text. Some examples could include:

• ‘I'd appreciate it if we don't talk about 'good' vs. 'bad' foods’

• ‘It would be really helpful if we could avoid any discussions of weight during the holidays’

• ‘I really want to have fun with you over New Years, which will be a lot easier for me if we don’t talk about diets’

• ‘It’s important for my recovery that we don’t talk about ‘working off’ Christmas dinner’

Responding to Body or Diet Talk

Despite setting boundaries, it’s possible that instances of unhelpful diet or body talk could still arise. In these situations, it can be helpful to have some practiced strategies for responding. Here are some ideas:

• Remove yourself: Remember it's okay to leave the conversation or the situation. Excuse yourself for a bathroom break or step outside for some fresh air

• Redirect the conversation: Change the topic to something more neutral or comfortable to steer the conversation away from diet talk

• Express discomfort: Be honest about your feelings, eg. ‘I'm not comfortable with this conversation’

• Question the body talk: Gently question the person engaging in body talk, eg. ‘I've noticed you make a lot of comments about good and bad foods. For me, this contributed to a really unhealthy relationship with food’

• Plant Seeds: eg. ‘I've found it helpful to learn more about my relationship with my body, if you're interested, I can send you some podcast or book recommendations’

• Direct Response: In some cases, you may need to be more direct and assertive, eg. ‘I'm not engaging in diet talk’

Focus on What You Can Control

Despite our best attempts, we have limited control over other people’s body and diet talk, and we may not always feel comfortable or have the capacity to challenge them. In these situations, focus on what you can control:

• Remind yourself of your personal journey: Tell yourself that you’re on the path to recovery and that it's important to prioritise your wellbeing

• Practice empathy: If it feels safe, try to empathise with those around you who might be caught up in diet culture, and be dealing with their own food and body image concerns

• Focus on positives: Concentrate on positive aspects of yourself, list three things you're proud of accomplishing

• Consider the source: Reflect on the source of comments and ask yourself whether it's helpful to place much value on their perspective

• Use mindfulness techniques: To let go of unhelpful thoughts, such as mentally saying, ‘I'm having the thought that...’

• Practice self-compassion: Engage in self-compassionate thoughts and soothing activities after challenging interactions

Prioritise your wellbeing, and before you know it the holidays will have passed – hopefully without too much stress or challenge along the way. Be sure to schedule in some of your favourite activities, and spend time with the people who you know are good for your spirits.