This post discusses topics (dieting, disordered eating, eating disorders, self-harm and suicidality) that may be distressing for some. Please access support services if required.

The Butterfly National Helpline 1800 33 4673
Eating Disorders Victoria 1300 550 236
Beyond Blue Helpline 1300 22 4636
Call 000 in an emergency

We are currently in an unprecedented time, where diet culture, social marketing media, weight loss drugs, and weight stigma have collided.

It’s incredibly frustrating to understand the evidence yet watch the harm being caused by influencers to an already limited public understanding of nutrition and health. Honestly, I am looking forward to the social media ban, because it might be the only thing that stops the next generation’s relationship with food and their bodies from being completely derailed.

Dieting is Disordered Eating

The difference between dieting, disordered eating and a diagnosable eating disorder is the frequency and severity of behaviours, the impact on quality of life and medical and psychological complications.

Dieting Behaviours	Disordered Eating Behaviours
Restriction Fasting Skipping meals Avoiding a type of food or food group Calorie or macronutrient counting	Restriction Fasting Skipping meals Avoiding a type of food or food group Calorie or macro counting Binge eating Misusing laxatives or weight-loss medications Purging Compulsive exercise

Eating Disorders

Dieting is the strongest predictor for the development of an eating disorder.

Prevalence

An estimated 1.1 million Australian’s (4.5%) are currently living with an eating disorder
With 10.5% of the population experiencing an eating disorder at some point in their lifetime
Since 2012, there has been a 21% increase in people impacted by eating disorders
They cost the Federal Government $4.7 billion each year
Women are twice as likely as men to experience an eating disorder
27% were aged under 19 (up from 15% in 2012)
Eating disorders are the third most common chronic illness in young women
Less than one in three people affected will seek help
Eating disorders have the highest mortality rate of any psychiatric illness with 1,273 deaths in Australia in 2023
You do not have to be underweight to die from an eating disorder

Eating disorders don’t discriminate, they can affect anyone, regardless of:

Age (eating disorders have been diagnosed in those younger than 5 years old and older than 80 years old)
Gender
Weight
BMI
Body sizes
Body shape
Skin colour
Culture
Nationality
Financial situation
Education level

Types of Eating Disorders

There’s a common misconception that eating disorders always present as someone being severely underweight, but in reality, this is far from accurate.

Anorexia nervosa (3%)
Bulimia nervosa (12%)
Binge eating disorder (47%)
Others (38%)

Medical Consequences

Psychological Consequences

Anaemias (deficiencies in iron, vitamin B12, folate, vitamin D, zinc)
Malnutrition
Osteoporosis or osteopenia
Heart problems
Chronic sore throat, indigestion, heartburn, and reflux
Inflammation and rupture of the oesophagus and stomach from frequent vomiting
Stomach and intestinal ulcers
Electrolyte disturbances
Fatigue and lethargy
Loss of or disturbance of menstruation
Impairment of kidney function, chronic kidney problems, or kidney failure
Impairment of liver, or pancreatic function
Gastrointestinal problems
Increased risk of infertility
Delayed growth
Cardiovascular disease
Type 2 diabetes
High blood pressure and/or high cholesterol leading to increased risk of stroke, diabetes and heart disease
Osteoarthritis
Death

Anxiety
Depression
Social anxiety
Social withdrawal
Low self-esteem
Extreme body dissatisfaction/distorted body image
Obsessive thoughts and preoccupation with eating, food, body shape, and weight
Feelings of shame, guilt, and self-loathing
Depressive or anxious symptoms or behaviour
Substance misuse
Self-harm or suicidality

Weight Cycling (yo-yo dieting)

Weight cycling or yo-yo dieting is repeated weight loss and weight regain, and it drives long-term weight gain, alters body composition toward a greater amount of fat verse lean muscle mass and increases inflammation.

Chronic weight loss and weight regain increases the risk for:

Hypertension (high blood pressure)
Hyperlipidaemia
Cardiovascular disease (heart disease)
All-cause mortality (death from any cause)
Obstructive sleep apnoea
Metabolic dysfunction-associated steatotic liver disease
Type 2 diabetes
Heart failure

Weight Stigma

Weight stigma is the discrimination toward people based on their body weight and size.

Weight stigma is particularly pervasive in healthcare. As a result of weight stigma and discrimination, people with higher weight as more likely to:

avoid seeking and engaging in medical care, leading to delays in diagnosis and treatment
engage in disordered eating, contributing the onset of eating disorder and increasing disordered eating in people experiencing eating disorders
experience higher levels of body dissatisfaction
experience higher levels of psychological distress, including stress, anxiety, depression, feelings of worthlessness and loneliness, and suicidal ideation
experience poorer quality of life
face discrimination in healthcare, affecting the quality of care they receive, leading to poorer health outcomes and increasing risk of mortality
face discrimination in employment and education
avoid physical activity and leisure pursuits

Weight stigma and discrimination have been shown to be associated with weight gain over the longer term, independent of the person’s baseline weight.

Weight stigma experienced from a health professional increase the following after controlling for BMI, health care delay or avoidance, sedentary behaviour, and selected demographic characteristics: