Eating Disorders and People with Higher Weight

People with higher weight or living in a larger body (or 'obesity’, as it is referred to in a biomedical context) is not an eating disorder or mental disorder. Language is important as labels can be stigmatising. While there is not one universally agreed-upon term for people with higher weights, the terms ‘people with higher weight’ or ‘living in a larger body’ are used to replace the terms ’overweight’ or ‘obesity’ here as many people with a lived experience have indicated this as their preference.

Body diversity is a fact of life and eating disorders can occur across the weight spectrum. An eating disorder diagnosis may be missed for individuals with higher weight as the perceived traditional stereotype of a person with an eating disorder is not observed. Weight stigma (discrimination or stereotyping based on a person’s weight) may also be experienced.   

Risk factors  

People with a higher weight are at increased risk of disordered eating compared with the general population, while individuals who use unhealthy weight control practices (e.g. fasting, purging, and diet pills) are at increased risk of being at a higher weight. Eating disorder risk factors are shared by people of all body sizes, including individual factors such as dieting, unhealthy weight-control behaviours, weight and shape concerns, and self-esteem issues. Other risk factors include social factors, such as parental and peer weight and shape-related behaviours, and societal factors, such as sociocultural norms, media exposure and weight discrimination.  In addition, weight stigma experienced by people with higher weight increases the risk of developing an eating disorder.

There is a significant co-occurrence of eating disorders among people with higher weight. Many people with higher weight have disordered eating patterns, and Australian evidence shows that the prevalence of both binge eating behaviours and severe restriction among people in larger bodies is increasing rapidly and increasing together (Da Luz F.Q., Sainsbury A., Mannan H., Touyz S., Mitchison D., Hay P., 2017). This may be due to social pressure for people at higher weight to lose weight and is of concern due to the medical and psychosocial risks of strict dieting.   

Body size and eating disorders are interrelated. Larger body size is both a risk factor for developing an eating disorder and a possible outcome for people with eating disorders. People with eating disorders who are at a higher weight experience a higher rate of physical and psychological problems than people at a higher weight who do not have eating disorders. 

 Media and public health messages

Eating disorders are characterised by extreme concerns about body weight and shape, and unhealthy relationships with food. This can apply to people at any size, and people with higher weight may be at greater risk because of the messages that society sends them about their body needing to be changed or ‘fixed’.

 A person may respond to this by:

  • Restricting food intake and initiating a starvation response in their body, which can occur at any size;
  • Feeling a loss of control around food and consuming a lot of it in a short space of time (a binge eating episode), which may or may not be followed by attempts to rid the body of the food consumed (through compensatory, or purging behaviours).

Some public health campaigns may perpetuate eating disorder risk factors such as preoccupation with body weight and shape, or restrictive eating.

Weight-loss services and eating disorders awareness

People with eating disorders are more than twice as likely to contact health professionals or weight-loss centres for weight reduction assistance than they are to seek treatment specifically for their eating disorder. Weight-loss treatments may contribute to the onset of disordered eating behaviours in people of any age, by increasing anxiety about body shape and weight and the development of unhealthy behaviours. 

Some signs and symptoms of eating disorders may initially be misinterpreted as treatment benefits. For example, increased physical activity and control and discipline over hunger and eating may be viewed as positive outcomes from weight-reduction interventions, but are also signs of increasing severity for individuals with eating disorders.

NEDC Report

The NEDC has published a systematic review of 134 studies which reported on obesity treatments and eating disorders, including dietary, exercise, behavioural, psychological, pharmacological and surgical interventions for weight loss.

The full review, including discussion of all treatment modes and their impact on eating disorder outcomes, study limitations and recommendations for practice and research can be accessed here

As this report was published in 2017, it contains outdated terminology.

See also

Disordered Eating & Dieting

Download the disordered eating and dieting fact sheet here.  

Disordered eating sits on a spectrum between normal eating and an eating disorder and may include symptoms and behaviours of eating disorders, but at a lesser frequency or lower level of severity.


Body Image

Download the body image fact sheet here. What is body image?Body image is a combination of the thoughts and feelings that you have about your body.


Eating Disorders in Males

Download the Eating Disorders in Males fact sheet here and infographic here. Eating disorders can affect people of any gender.


Eating Disorders and Diabetes

Download the Eating Disorders and Diabetes fact sheet here.  

If you are living with diabetes and experiencing disordered eating or an eating disorder, you are not alone.  Anyone living with diabetes can be at risk of developing an eating disorder.


Risk & Protective Factors

The elements that contribute to the development of an eating disorder are complex, and involve a range of biological, psychological and sociocultural factors.


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