Feeling “Not Sick Enough” but Still Struggling

It is very common to minimise eating difficulties.

You may know that your relationship with eating, weight or your body is causing distress, but still tell yourself that other people have it worse.

Perhaps you are eating regularly enough to get through the day. Perhaps your weight does not look concerning to other people. Perhaps you do not have a diagnosis, or your eating does not fit neatly into one particular category.

That can make it very easy to think that you should just get on with it.

But distress does not have to reach a particular threshold before it matters.

The idea of not being “ill enough”

Eating disorders and disordered eating are often associated with very narrow stereotypes.

People may imagine that someone has to be visibly underweight, frequently purging, bingeing every day or medically unwell before their difficulties count.

In reality, eating problems exist across a wide spectrum.

You may be functioning well in many areas of your life while still spending a huge amount of time thinking about eating, weight, shape or control.

You may look completely well to other people and still feel exhausted by what is happening internally.

What this might look like

You may recognise some of the following:

• Feeling guilty about eating

• Restricting at times but telling yourself it is not serious

• Bingeing occasionally and dismissing it because it does not happen often enough

• Worrying about weight gain but feeling that everyone worries about that

• Feeling uncomfortable in your body most of the time

• Thinking about eating far more than you would like

• Comparing your eating with other people

• Feeling anxious when your routine changes

• Avoiding certain foods without really understanding why

• Feeling embarrassed to ask for help because you think someone else deserves it more

• Believing you should be able to sort it out on your own

Sometimes the difficulty is not that there is no problem. It is that you have become very good at explaining it away.

Comparing yourself with other people

Comparison can be a powerful way of minimising your own experience.

You may think, “I am not as thin as her”, “I do not binge as often as they do”, or “I have never been in hospital, so I cannot be that bad”.

But someone else struggling more does not make your own experience less important.

There is no prize for waiting until things become worse.

Therapy can be useful before an eating difficulty becomes more entrenched.

You do not need a diagnosis

A diagnosis can sometimes be helpful because it gives a name to what is happening.

But it is not a requirement for therapy.

You may have eating patterns that cause significant distress without meeting the full criteria for a particular eating disorder.

You may also find that your difficulties shift over time and do not fit neatly into one box.

What matters is how much they are affecting you.

The cost of keeping going

When something has been present for a long time, it can start to feel normal.

You may get used to planning around eating, avoiding certain situations, checking your body, feeling guilty after meals or constantly negotiating with yourself.

Because you are still functioning, it may not feel urgent.

But that does not mean it is not taking something from you.

The cost may be mental energy, confidence, spontaneity, social freedom, enjoyment or simply the ability to think about something else.

How I work when things do not fit neatly into a label

My approach is integrative, which means that we can begin with your experience rather than with a diagnosis.

We can look at what is happening around eating now and also at the emotional and psychological factors that may be contributing.

Depending on what feels relevant, our work might include:

• Understanding patterns around eating

• Exploring restriction, bingeing or compensatory behaviours where these are present

• Looking at body image and self criticism

• Understanding the role of weight and shape in how you see yourself

• Exploring anxiety around eating

• Looking at perfectionism and control

• Understanding emotional triggers

• Developing a more regular and flexible relationship with eating

• Exploring earlier experiences that may still be affecting you

• Reducing the amount of mental space taken up by eating and body concerns

I draw on person centred therapy, CBT and CBT E informed approaches, transactional analysis, psychodynamic thinking and psychoeducation, while adapting the work to the person in front of me.

I also hold a Master Practitioner qualification in Eating Disorders and Obesity and have specialist training and experience in working with eating difficulties across a wide range of presentations.

You are allowed to ask for help now

You do not have to wait until your eating becomes more restrictive, your weight changes, bingeing becomes more frequent or your physical health is affected.

You do not have to prove that you are struggling enough.

If your relationship with eating or your body is making your life smaller, more anxious or more complicated than you want it to be, that is reason enough to talk about it.

Online counselling for eating difficulties

I offer online counselling for adults across the UK.

Therapy can provide a private space to make sense of what is happening without needing to justify it or fit yourself into a particular category.

If you would like to talk about whether counselling might be helpful, you are welcome to get in touch.