Life Uncut - How Do You Feel When You Look In The Mirror? Disordered Eating with Dr Kieran Kennedy

Episode Date: July 31, 2025

Disordered eating is something that so many people, especially women, have experienced. Sometimes this is so normalised by society that we don’t even realise our approach to food is disordered or could be defined as such.  We’re joined by psychiatrist Dr. Kieran Kennedy. Kieran is consultant psychiatrist specialising in the diagnosis, support and treatment of a range of eating disorders and body image struggles; everything from binge eating disorder, bulimia nervosa, body dysmorphia and the intersection between fitness, appearance pressures & mental health. Today we speak about: How you may have disordered eating without even realising it Women identify more with disordered eating but rates of men and all genders are increasing - ‘muscle dysmorphia’ The messaging around weight and eating is deeply ingrained in our culture ‘Health and fitness’ may be disordered eating in a different costume Our relationship with food can impact our social and romantic lives Whether you can comment on someone’s body  Body image in the ‘ozempic era’ The link between disordered eating and depression, OCD, anxiety and ADHD Binge eating disorder is by far the most common eating disorder How we can recognise concerning body image thoughts in loved ones and kids   If you’d like to check out Dr Kieran Kennedy’s Instagram  You can access Dr Kennedy’s clinical practice here  You can watch us on Youtube Find us on Instagram Join us on tiktok Or join the Facebook Discussion GroupSee omnystudio.com/listener for privacy information.

This episode was recorded on Camaragal land. Hi guys, and welcome back to another episode of Life Uncut. I'm Laura. I'm Brittany. Today's episode is one that, well, firstly, we needed to get an expert in for, but it's also one that's been requested so many times over the years. And I honestly can't believe it's taken us this long to do a deep dive into this. We're going to be talking about disordered eating and eating disorders. I know that this is an episode that's going to be very close to home for a lot of people, but I think one of the things that's so interesting about

this conversation is that there is such a huge spectrum when it comes to disordered eating. Things that we have completely okayed across society where we say, oh, like if you're doing it for fitness or you're doing it for health reasons, then that's all right. We have a lot of ways to justify it to ourselves. Well, I think it'd be surprising to a lot of people, And maybe after this episode, they even realize what disordered eating is and how it affects their life without them even knowing. And, you know, I think sometimes, I mean, there's obviously the psychiatric side of it, which we will get into, and we are not qualified to speak on that, hence why we have

someone extremely qualified in the room. But then there's also the social side of it. You know, we've all grown up with the magazines, with Heroin Chic. We've all grown up with seeing the examples of what a traditional beauty looks like. and now we are kind of given the example of what health looks like and sometimes I do think it is disordered eating dressed up as a health and that's what we're being sold but I'd love to introduce you guys to Dr. Kieran Kennedy if you have listened to the cloud series that producer Keisha created around ADHD and late age diagnosis it is fantastic if you haven't listened to it yet

and if you have listened to it you will know who Kieran is because he features across that series so much. Dr. Kennedy, he specializes in ADHD, and through his psychiatric training, Kieran trained in supporting severe level eating disorders in hospital settings. He's a consultant psychiatrist specializing in the diagnosis, support, and treatment of a range of eating disorders and body image struggles, everything from binge eating disorders, bulimia nervosa, body dysmorphia, and also exactly what we were talking about, that intersection between fitness, appearance pressures, and mental health for both men and women. Kieran, welcome to the pod. That was quite the... Gotta get it all out there. I'm like, I do all of that? What?

You actually do more than that. We couldn't fit it in. I'm like, who is this? We also, I mean, it's funny because we were speaking about it earlier when we said that we were going to have this discussion and Keish put it into our discussion group that you were coming on. Someone made the comment around, but why would you get a man on when this predominantly affects women? And so we talked about like, okay, well, we've got to prove like you are so incredibly qualified to speak on this topic. But I mean, even as an interesting place to start, why is it that women are so predominantly affected by this? Yeah. Well, and I mean, thank you so much for having me guys, man or not, but you know, it's just so, so great to team up with you guys as

always, but this is just such an important conversation. And I think, as you say, women are going to be predominantly kind of affected here and we know that they are compared to men. I think that has a lot to do with those traditional societal pressures and that's what we know kind of can really kind of hotwire this for women and girls in particular. All of those pressures around body image, weight, appearance, beauty, all of these standards that have been funneled and pushed along all of these decades in terms of that being around weight and appearance. And second to that, what we eat as well. You know, I think we're going to touch on the fact that especially in 2025, men and people of all genders now are increasingly sort of catching up in terms of struggles with body image and eating. But traditionally, this has really been a place where women in particular have had the brunt of those pressures. It's crazy because I don't think I know a woman who hasn't had an issue with their body or disliked their body or probably don't think about their body at least once a day in some capacity.

The way they look or can they wear something or did they eat well today or could they have eaten better or what could they could change in their life? Do I need to go on, you know, a wedge shred, which is all the things, you know, I can't talk. I went on a wedge shred, but why are we so conditioned to do that? We are going to get into that. But I think let's talk about how you found yourself in this space of eating disorders and disordered eating. Yeah, a bit of an interesting one, a slight curveball. But obviously my medical and then psychiatric training, as Laura said, that moved through

a period where I really focused on work in hospital medical settings, supporting people with severe and high-end eating disorders, supporting them when medically they needed a safe space to be refed basically and supported medically. so that really sparked an interest but then at that same time and in the years before i'd also been moving through work and competitions when it came to bodybuilding and also a bit of fitness modeling here and there if you guys are watching this visually on youtube now kieran has very big biceps you can tell that he used to be a bodybuilder they're just inflated for today i did like some press yeah you did some part before you came in i'm on camera just upper body so you were

a bodybuilder. Yeah. And so I obviously had that real passion there and then a passion for psychiatry. And it was super interesting how I just had more and more guys in the gym or at competitions even coming up, knowing that I was working in mental health and asking me questions around body image and elements of eating and is this disordered eating? And it was that that kind of really spurred me to be working in the area with men and then threw into a real interest for supporting women when it comes to appearance and body image pressures too. How does it get defined? I mean, in terms of like a clinical definition, we've kind of established that so many people have disordered eating, but when does it cross the line between being like, okay, well, that's just

something that most people experience versus being an eating disorder. Like how do you differentiate between the two? Yeah, really tricky, you know, and I think we have the DSM, for example, our diagnostic manual for psychiatry. And this is a group of people in America who have decided where certain cutoffs lie for symptoms and what is and isn't a disorder which we won't go down that rabbit hole because there's a whole argument against that but i think for me it's around appearance and eating related struggles coming to a point in our lives where they start to really impact how we function in our work in our social lives in our relationships and they start to really negatively impact not only elements of our mental health like significant distress

We're thinking about this all the time. It's starting to become a driving force for our life, but also especially with eating disorders, our physical health sometimes as well. So I think when it crosses a line to becoming something that is starting to really take up a huge chunk of our internal and external life and having consistent negative effects on our life and what we want to be doing and achieving, that's where for me it becomes something we need to get support with. Do you think in your professional opinion, we are wired to be susceptible to eating disorders or do you think that it's just a product of the world we live in and the media that we are bombarded with every single day? Yeah, it's, you know, the classic psychiatrist, I guess. It's like chicken or the egg. Yeah, it's complicated and it's super complex. We know that the societal cultural aspect is a huge part of it.

you know western cultures industrialized countries rates of these more traditional eating disorders like anorexia bulimia binge eating disorder are significantly higher in these countries where those cultural societal pressures around weight and appearance and beauty standards especially for women are pushed predominantly but interestingly we also know that elements of disordered eating and body image struggles have been present across society for centuries now and they exist in other countries where those more traditional weight-based elements of pressures aren't there as well we know for things like anorexia and bulimia there's also a genetic component so there is some level here of eating disorders running within families and

there's a genetic biological component there that we're not quite sure the exact reason why so it's a bit of a mixture of sort of biology and our genes but also these pressures that kind of supercharge the risk that someone might have for an eating disorder? I can imagine it makes it almost impossible for some people, one, to seek help or two, to actually conduct diagnosis. Because when you say it, disorder eating crosses into an eating disorder when it's manifesting someone's entire brain space, you know, when it's taking over normal aspects of their life. But I would dare say that often it's family members or people close to that person who identifies, hey, this is a problem. The person

might individually realize it's a problem, but not actually want to do anything about it. They're talking about it with their friends. They're not talking about it with their parents. They're not talking about it to people around them. But it's when you say, she's only eaten a tomato today. Like she's not, you know, like, and you notice in your friends, actually, they've lost heaps of weight and they're not necessarily eating or behaving normally around food. But sometimes it's our friends who witness it rather than us being able to admit it ourselves. Definitely. And it's really insidious kind of how it happens because a lot of eating disorder and body image struggles, they're actually socially reinforced, you know, and so the person sitting

with a little bit of a sense of, I'm not sure if this is something that is serving me or I feel a little bit like we're starting to go down a pathway maybe I shouldn't be. The tricky thing is that in society, they're often also reinforced in a way by all these bombardments of social media, people often not with any undue kind of negative impact but making comments on my god you look great you've lost so much weight or for guys oh my god you're looking jacked or look how lean you are and so all of these little reinforcers can make it really hard to identify that something has become a problem but also when you're in the eye of the storm like any mental health condition it's really really hard to kind of see that something's impacting you i remember being in my 20s and

working in office space and I worked with this young girl she was a bit younger than me and one of our bosses had made a comment about her weight and she was just a normal normal sized girl I mean whatever classifies as normal but she was probably what size 14 and one of our bosses made a comment about her weight and she didn't say anything but she was instantly you could tell she was very triggered and at the time I was what do you mean said something about their weight negative negative about her weight not like no no no it was like negative it was like made a joke when we're at dinner and now at my age and also like at my understanding I know I would have said something back but at that age I was like 23 myself and I also was like don't want to lose my job you know

I'm never going to stand up to the six-year-old CEO of a company and you could tell that like something in her kind of snapped and anyway from there she would come to work and she would have like a can of tuna or a tomato and and she started to lose weight really dramatically really dramatically but everyone was telling her how amazing she looked she would end up going overseas and I remember going over to visit her and I got there and I was like it took my breath away how much weight she had lost and it was I really saw the pattern of how the positive reinforcement had almost like put her on this trajectory of being able to persevere and it took a lot of rewiring for her to get well again but she definitely went down that track and it was so frightening to see

how quickly it happened because this absolutely isn't to demonize goals that someone might have in terms of their fitness or appearance or weight but I think that's so important as well because with eating disorders and body image related disorders we can start on this kind of pathway for whatever reason obviously in this case not okay in terms of how that was triggered but these kind of thoughts habits intrusive cognitions or behaviors they can very easily kind of get locked into a cycle where we can really start to lose control with it. And that's also where I think a lot of the eating disorder side starts to creep in, is when we're actually losing a sense of control around how and where and why this happens. Is an eating disorder classified

as an addiction? I know that's an unusual question, but I'm assuming recovering from an eating disorder is hugely mental. Definitely. And, you know, it's not classed in the same category in terms of addictions or addictive disorders but we know there are significant similarities even neurologically in terms of areas of the brain getting these dopamine hits and reinforcers and a lot of patients that I see for things like binge eating disorder especially it's often tied to a period of significant stress or low mood or when we've had something happen in our lives that's really really difficult and in this roundabout way the eating disorder provides some sense of reinforcement because it offers a sense of control and stability. If I can't control anything else in

my life right now, I can control what I'm eating, what's going into my body, what then happens after that. And also things like purging as well can really start to lock in because we know that there is a real reinforcing and in a roundabout kind of maladaptive way, comfort sometimes that can come with these behaviors happening. So it is really similar in some ways. And there's so many different types of eating disorders as well, which I think it's tricky to cover everything with the one brush. Are there different triggers that would mean, okay, well, this person's more inclined to become anorexic. This person's more inclined or at risk of developing bulimia. And what does that look like? Yeah. I mean, I think the key thing to know is that there are some baseline

risks genetically and or otherwise for eating disorders on the whole. And people are often kind of surprised and quite shocked to hear that it's really common across someone's life for them to move through different diagnoses of eating disorders. If someone moves through a period of anorexia nervosa, it is incredibly common for them to also then at times move through periods of bulimia or binge eating disorder or other body image and eating disorder struggles. So there's sort of some, I guess, foundational links to all of these conditions. But in my mind, the psychological and kind of background reasons that trigger specific behaviors or pathways that might go down are the key so if someone might have that foundational risk for an eating disorder

but they grew up in a home where that pressure around weight or even for example a parent figure being very kind of focused on eating very quote-unquote clean foods or small amount of foods or monitoring their own weight that might be a potential pathway where risk for anorexia nervosa in particular is increased. So I think the history that someone goes through in terms of their family, traumatic events, comments that a boss or a past partner or someone makes, it can sort of trigger us down these different pathways for struggling. What are some, I mean, I want to say one, but what are some common misconceptions around eating disorders? I know one of them, and I'd love you to expand on it a little bit, is that you don't

necessarily have to look unwell to have an eating disorder. Like when we use the term eating disorder, we associate it with like really, really malnourished and skinny and hospitalized to be fed. What are some of the misconceptions and like, why do you not necessarily have to look unwell? Yeah, that's like such a perfect one to start with. Cause I think when we think eating disorder or we hear that term, we still, as a society, as a culture are stuck in that image of anorexia nervosa, you know, someone who's really, really skinny or thin, but that is not what the majority of eating disorders look like at all. So I think that's key because eating disorders come in all types, all flavors, and they are still significantly impacting people who on the outside,

you may not look at that person and think this person is really struggling with an eating disorder. I think the other big one that I want to push here is that eating disorders do predominantly impact women and girls still, absolutely. But we are also now seeing eating disorders and body image issues really coming through for people identifying as non-binary or people of all genders all ages men now as well and young boys are becoming more and more pulled into this concept of muscle dysmorphia for example so it's again a sense that eating disorders aren't just something that affects wealthier women in western societies who are too thin i would almost think and go as far as to say that it's always been there within men like it's

always been an issue it's just that men never had a platform or felt comfortable to open up about it and say hey you know what like we have it too and i say that because i think back to a lot of men in my life even in the last 10 years i know so many men that have had issues with eating and their body and body dysmorphia and people that you would never think people that feel insignificant i still hear people talk about it at the gym now in the saunas like bro guys you know like big like it's everywhere and I think it always has been I think men just haven't ever felt comfortable or had the space I think that disordered eating has evolved you know we used to know that it was very much like like we mentioned this heroin chic kind of look once upon a time but now we're really

especially across social media talking about the fitness industry and counting macros and counting this and you know now it's it's okay to fast for 48 hours because it's really good for rebuilding micro micro microchondria mitochondria mitochondria i know what i'm talking about mitochondria but like we've all heard it right and i guess like in theory there is benefits to some of these things but how do we know when fitness and health is actually disordered eating dressed up yeah and again i always like to call out within any of these things whether it's the modeling industry or the fitness industry and all these things it's not demonizing these things to say they are necessarily just you know a boiling pot for eating disorders but as we said before they can

so insidiously slowly turn into pushing pressure points that can become quite maladaptive and you know i think when it comes to the fitness industry it's knowing that again that amount of pressure thought preoccupation tying of self-worth and esteem to looking a certain way being a certain muscle mass or weight again that's kind of fertile ground for thoughts about how much do i weigh how much my abs popping have i fasted this week what should i be eating for lunch those things can very easily tip into becoming something that starts to take control of our life and starts to negatively impact us and i think going back to what brit asked before around some of the misconceptions in 2025 it's now knowing that we can be struggling with an eating disorder

actually without it even meeting criteria for anorexia nervosa or bulimia or full binge eating disorder. Because I meet people nearly every day in my clinic where they are significantly impacted by body image and eating disorder type issues, but they might not actually fall into a category of a clear defined disorder, but it's still really impactful. I had this conversation last night with my husband ben and i have i spoken to him and asked if i can you know mention this on the podcast and he said yeah it's fine but i said to him you have a form of disordered eating and it is really common i think this is why it's important to talk about not just in men but that intersection between like in the fitness industry and athletes ben has been an athlete

since he was 15 his whole life but he went professional at like 15 and a lot of people don't know but in the sports world this is in all sorts of industries team and individual football particularly like they are constantly weighing you they are doing your BMI and they are doing fat tests and you have to be under a certain level or meet criteria and if you're over it then you've got to do it again in a week and you know meet criteria so they are constantly getting fat testing what that has done to Ben without him even knowing is he will eat I want to put this in quotations something bad which he loves he loves sugary sweets he loves carbs he loves pasta and he needs that to train he will eat something and then he'll be like i've got to

go work out because he correlates these two things of like and i'm about to be fat tested or he'll be like my fat test is next week he'll just eat chicken and broccoli for that week because he knows and what that has done is like every week it is of course i think it has caused issues with him and he's aware of it he's aware that you know i said just because you ate something bad now does not mean you need to go to the gym he's like i know but it's just easier for me to stay on top of it and he's aware of that connection and so many men in his world experience that on a day to day and that would fall under a classification of disordered eating right absolutely you know there's clearly an element there understandably and like so many men and so many women where

there's that spark of real anxiety or kind of emotional triggering there where we're sort of like well I've had this big bowl of pasta so now I am not going to feel comfortable or okay until I go for that run or until I go to the gym or maybe we start saying well tomorrow I'll have two workouts to kind of cancel it out and balance it out and I've been in that place as well in terms of that bodybuilding fitness modeling kind of world that creep starts to kind of creep in there even though potentially have been obviously for example went to a psychiatrist and they just looked at the diagnostic criteria for an eating disorder they might say well you don't fit any other criteria for this so you don't have an eating disorder so it's okay i guess i just want

people to know that struggling with an element of worry and anxiety and preoccupation around your body image but also how you eat and things that we have to do after we eat experiencing that and worrying about that, even if you don't feel like it's at a point where I'm quote unquote sick enough or I don't meet criteria, you are still so valid in feeling that this is something that isn't serving me or it's impacting me and maybe I want to get some support with it. I would love for us, I mean, I know we love a poll here at Life Uncut, but I would love to know how many people now reflect back on their life and go, okay, either yes, now still currently, or at some point I had a very disordered approach to the way I would say

most people, and I don't want to trivialise it because I know the spectrum is so severe but it's so vast, but I think about when I was in my 20s and at my absolute most food obsessed when I wanted to be the smallest I could be and I was like very, I think about it now and it was all I thought about. I'd walk past a window where I could see myself and I'd check to see what size I was. It permeated my entire brain, everything.

I was on my diet, which I'd rationalized to myself, was I couldn't eat anything until 3 p.m. in the afternoon. And then at 3 p.m. in the afternoon, I could eat whatever I wanted so long as it fit into one bowl. So I had one bowl that I would eat. Which also doesn't even make sense because you could put 50 Mars bars in a bowl and have your weeks in a can. My brain immediately went to what you could fit in a can.

Yes, but it was always like, you know, dinner or curry or something, like something that if I was eating on a diet, I would have portion controlled so I was like well I can have a decent serve of it I haven't eaten all day but I'd be finished that by 3 30 and then I couldn't eat again until the night time just water and like I did that for months and I was so tiny like tiny tiny tiny and I think that my family knew I was doing it I mean they must have like but no one ever was like that's really fucking weird and like not an appropriate way to approach food like no one ever intervened I only got the positive affirmation about how great I looked so it really propelled me to keep doing

it until it became, you know, I would even not go out for dinners with people or like stop doing social things or go on dates. Like, because I was like, well, I can't do that because it has to be around my timeframe of being able to fit in my bowl. Like it was fucking wild. But we also grew up at a time that the fads were a thing. Every couple of months was a different way to eat. Lemon detox.

But fast till three, that's it. Only eat meats and proteins. That's it. But even if you had gone to see a psychologist or a psychiatrist, for example, it might not have fit into these boxes that have been kind of made to believe you have to be at you know and I think something else I just want to mention there as well is the side to eating disorders and body image struggles even if they're sub-diagnostic that social life part that you mentioned Laura is so important to pull out as well because it's not just about weight and physical health and

depression and anxiety it is those things obviously but I talk to so many people and I can even think about myself when i was doing the bodybuilding stuff when i was younger it's saying no to a date because you feel like well i wasn't too on to my training diet yesterday so i can't go out to a restaurant tonight or it's the skipping family meals or you know being a little bit untruthful to family about the fact that yeah i already had lunch and yeah i had a huge lunch i'm full you know it's the little subtle powerful ways that it can kind of start to creep in and affect how we're engaging with work and our social lives and our friendships and our families that can be a really huge part to these things as well do you think i mean you know we've talked a little bit

about how it's evolved over the years and like how it's kind of fallen into this fitness category but also i mean social media in and of itself means that everyone can find a community right like you can find a community with whoever you want and there are a lot of really disturbing communities on social media especially I mean my kids are little so I don't have to worry about this yet but I think of like parents to young teenagers there's so much pro-anna is what it's called content online that either tells people how to be better at restricting your intake to be able to like get around those sort of social situations and stuff it's like all the tips and tricks as to how to do it and do it well how does that impact and do you think that there's been an increase

in people with disordered eating or do you think it's just that people will always find new ways to be able to justify what it is that they're doing. We know that rates of eating disorders have been steadily increasing in a lot of ways for some time. I mean, even just if we look at rates in Australia at the moment, sort of between 4% to 5% of Australians have an eating disorder in some form. So that's over a million people even just right now in Australia. And then across our lives, up to 10% of people will go through

an actual diagnosable period of an eating disorder, which is nearly kind of two and a half million people if you look at the population, for example. But God, if we then take it under that, how many people are not meeting diagnostic criteria or are falling into these spaces online and with social media pressures and things where they're adopting elements of disordered eating and body image pressures that don't meet a diagnosis? Yeah, those numbers would be far higher huge it's astronomical so you know i think that intersection with social media especially for young people too is huge especially because it doesn't have to even be something as explicit as that we are still getting just bombarded every day with these implicit messages around look at her or

look at him really successful has a life that i want and part of our brain even if we don't consciously register it might then also register really thin or looking really ripped or looking really lean and so our brain digests that especially for younger success and links success an amazing relationship being beautiful having 200 000 followers part of our brain subconsciously links these things to appearance or weight or body image and that's the really kind of dangerous part of this in social media too. We've made a lot of headway I think you know obviously there's way more conversations about it and there's a lot more conversations online around body inclusivity and everything as well but I do think we'd be remiss of saying that body inclusivity still only includes

a specific type of person like when we talk about people of a bigger size or it's always they always look a certain way though it's not like the inclusiveness doesn't span across all body shapes and sizes and I do still think that there is this like unevenly weighted aspiration towards a certain physique that you know is still upheld as like well this is the standard of hot and this is not and we still see that even though there is more diversity it's such a tricky space now because the example that just popped into my head is Lizzo Lizzo has always been at the forefront of body inclusivity and owning who you are and she's obviously a far more curvier woman and she's recently lost a lot of weight and people because she chose to she wanted to she

didn't feel forced to she said she feels better than ever you know and people have turned on her because it's almost like yeah if you're big you're always big you don't get to you know you you don't get to betray us from losing weight and i think it's a really tricky area and i'd love to link this back to the reinforcement i think a lot of people struggle with what you can say and when you can say and how you can say it because we pretty blanket statement you shouldn't comment on someone's body, right? Like if someone's lost weight, don't say you look great because that could be triggering an eating disorder. We're aware of that. But I think there's a lot of times, and I would love your expertise. There are a lot of times people do need to lose weight.

It's causing heart issues and high cholesterol and diabetes and whatever else, thyroid issues. Those people do need to lose weight for health issues. I've had people in my life that have had to do that. And those people that are on that battle, they do need reinforcement and they do need encouragement so we they do they need to be like you you know you're doing so well you're looking great you're feeling great what is the line because i know a lot of people would struggle because it's so in your face in social media don't comment on someone's body but i personally think that there are times that you should for those examples what do you think really tricky i guess probably my best advice and where i would first go to here is feeling like we are in a space where

we know that person's journey yes you know what i mean because i think someone can have significant struggles and negative health and mental health impacts that are associated with weight you know that we know that yeah excess body weight can for some people cause risks with heart disease other elements of their health but we know that for some people it also might not be causing those issues yes and i should have specified sorry i'm talking about people in your life when you you're trying to support them but you don't know what is the right way yeah and so i think having almost like a conversation with them around those elements and in terms of how they're feeling about that or what their goals are about that the health related kind of impacts the mental health related

impacts because i think if obviously we get a clear sense that for someone losing weight for them is a real positive that is going to and is benefiting them physically and mentally i think supporting them within that and being alongside them within that is helpful and maybe it's more about the question is more about like how are you feeling like are you feeling great not like necessarily that you're looking great like tell me how you're feeling after you know you've lost this kind of weight absolutely but but i agree with you i think kind of a blanket fear that it has also been pushed at times around never talking about weight or appearance or food with people including people that we love and are close to, I don't think that's necessarily helpful because

then in a way it only kind of keeps all of this stuff really kind of siloed and secret and shameful. What about the, I mean, we're in the dawn of Ozempic era. Like, I mean, it's everywhere. It's everywhere. It's everywhere. Do you think that this is going to impact or further impact, or has there been any sort of, I guess, data so far on how it's impacting people's mental health around their body image and also around the accessibility of thinness yeah i mean i think we're waiting for that data to come out now in terms of the consequences but i agree again a real double-edged sword potentially in terms of again pushing that narrative around thin is better thin is better and success is linked to looking this specific way and success and happiness is linked

to losing weight or being at this weight. I can absolutely see as a psychiatrist working in this space, how that is potentially really dangerous for again, kind of just influencing and pushing people in that direction around weight loss. Is there a link, a direct link to disordered eating, eating disorders and other conditions like OCD and ADHD and anxiety? Yeah, absolutely. So we know if someone is struggling with another mental health condition or struggle like depression, anxiety, OCD, they are more at risk then of also having a comorbid eating disorder. And some of that probably again comes down to those foundational kind of genetics and predispositions we talked about. But I think also eating disorders in

particularly can become linked to reinforcing or comforting or being part of those struggles. And as we said before, I talk to a lot of patients who feel like when their anxiety is flaring and in a more difficult space, that's when their eating disorder symptoms also really ramp up because in this implicit subconscious roundabout way, the control of the eating disorder and things kind of almost acts as a little bit of a quell for anxiety. ADHD and neurodivergence for example we know now has this significant link to binge eating disorder in particular and so there might even be elements of impulsivity and having a craving or an urge and not being able to hold that urge that specifically then also really flares this risk for binge eating disorder for those who have ADHD so it's all definitely combined and kind of chicken and egging type sort of thing as well we haven't even really touched on binge eating yet, but what would you say is the most prevalent eating disorder out of, I want to say

the more common, which is binge eating anorexia nervosa and bulimia? It often shocks people that binge eating disorder by a whole mile is the most common eating disorder by far. Again, I think that's surprising for a lot of people because when we think eating disorder, we think anorexia nervosa, we think bulimia, but far and away, the most common eating disorder at the moment is binge eating disorder. And so it's one that we actually don't talk about a whole lot. And a lot of people don't even actually know what binge eating disorder is. So I guess just to dive into that slightly, I mean, binge eating disorder is when there isn't necessarily a significant focus on losing weight or needing to be thinner or needing to look a certain way. And there's not a reflex of

I've had this food and I need to get rid of this food somehow with vomiting or laxatives or another mechanism. Binge eating disorder is when we are falling into these recurrent periods of losing control with how much we're eating in a defined period. They say two hours in the DSM, but I think it could be any period of time. And it's associated with things then like feeling significant disgust and shame or anxiety afterwards doing it in secret because we feel ashamed or embarrassed a significant amount of time planning and thinking around what we might eat or collecting the food together that we might have later and so binge eating disorder in that sense is super common but also it's common even if it's not to that diagnosable point i think all of us in some way

and so many people can relate to periods of time where we felt like i lost a little bit of control there or I had a really terrible day at work and then I ended up. That was my treatment for it. That was my, you know, some people go home and have a glass of wine. Some people go home and eat two pizzas. Yeah, I sometimes still eat until I make myself sick. But it's not an eating disorder. I just like maybe I just eat too quickly.

Like I often will. That's different. No, that's what I'm saying. But I will still eat until I feel sick. I don't know why. I'm only just realizing it now. The number of times I'm like I feel I'm well with how much I've just eaten. I do too.

But I think that everyone does that to some extent. I feel like that's more like a pacing thing or like, do you know what I mean? Definitely a pacing thing. You've mentioned a couple of times the idea of shame around food or shame around not just food that we might intake, but like, you know, shame around actual disordered eating. How do you suggest people approach conversations with either their friends? But I'm also really interested from a parental perspective, like if you're a parent and you're concerned about your kids or the way that your kids might interact with food, how do you have these conversations with them in a way that doesn't exacerbate it or demonize it and to try and kind of chip away at what's actually happening? Yeah, not easy. I think just to put that out there, especially for parents, even for kids, I think it's an element of, again, knowing and exploring that person's actual experience is the important thing.

Is something we're noticing tied to them actually feeling anxious or worried about that or because they've heard something or been told something about them or their weight? Or is it something that we're seeing that's actually connected to something completely different, like a loved one having seen the doctor and been told for your heart? you should start getting your meals smaller. So I think not being afraid to ask people in our lives how they're feeling in terms of their sense of appearance or weight or their food, I think that broaches the discussion to get their sense of what's happening and what's driving that thing. Especially with kids and teens, the modeling side of it from parents we know is super impactful and important so watching how we talk about ourselves and our weight or we talk about our own eating or meals you know kids especially are just sponge to the max in terms of just picking up all these

little things and being like oh mum seemed upset or slightly anxious or her face changed in terms of when she mentioned she shouldn't have eaten that or that she doesn't look good in something or yeah so I think it's watching those elements and knowing that that on its own can have a real positive flow on effect if our kids aren't soaking up those messages but again i think for kids and obviously it's an age-based thing in terms of what they can kind of conceptualize but it's not being afraid to have discussions around how we're feeling about our body or what we eat the focus being on eating for health and strength and happiness rather than food constantly being tired to weight and appearance and what's bad for you exactly what's the age group we haven't

really touched that that is affected most by eating disorders uh so young people predominantly teens predominantly so a third of all people with eating disorders in total a whole third of that chunk are below the age of 19 so if you think of like the whole range of people and how many people have eating disorders it is something that significantly pushes and pressures young people and again there's a whole lot of reasons for that but i think one of the reasons is that as all of us know when we're in our teens those concepts of what do others think of me how am i comparing to my peers am i liked am i accepted am i someone who's being asked out am i attractive all of these things are in a little pressure cooker during that period where we're trying to figure

ourselves out. And again, I think that's where those roots of kind of body image and eating struggles can then really kind of latch on there. So it is something I think we should be thinking about talking to our young people, our kids and teens more, but it's also something I think we can be remembering that if we are modeling, especially kind of how we're talking and going about our own kind of dynamics with food and eating and fitness and weight that can flow on into young people too I always say I feel like we are the generation we're like the self-help generation of parenting I don't know I mean I don't know what the impacts of that is going to be but you know there's so many tools out there now to do things better or to have better

conversations with kids and I think for the most part parents in general want to do a good job they want to be good parents of course there's shitty parents out there but like I would say most people are trying to be a better parent and potentially even be a better parent than how they were parented and so you know i think for a lot of us we have these blueprints of potentially how our parents spoke about food to us because they didn't have the reference point for it they didn't know that one way was damaging and one way wasn't i know my dad did this like the protein cheese diet you know all you eat is like salami and cheese yeah i'm like i did it i remember being like i'll do that too we did everything but you don't they don't know

I remember coming home from the uni bar one day and I'd put on a bit of weight in uni as everyone does. That's just what you do at uni. And my mum was like, are you sure you're not pregnant? And I was like, cool. That's not helpful. You're like, possibly, but that's not. You're like, now I'm worried about something else.

The thought of that now. And I obviously bless my mum. She's a great mum. She would have no idea how insulting that was. She was just like, you know, it was her way of trying to tell me that she thought I put on weight. Irrelevant. Who cares?

But I now know, like, as a parent, like, you would never fucking say that to a kid. But we only know it from how much we have these conversations. Totally. They weren't exposed to what we were exposed to now. The info that's out there now is just, you know, and in all little different ways. Like, I remember my dad bringing me and my brothers out to, like, the garage home workout thing. Even when we were, like, I think 10 or 11 years old. Lifted.

Be a man. This is how you work your biceps. Yeah. now like seeing young guys with body dysmorphia and stuff I'm like oh shit to be fair though I still think that side of it exists I think that like kids are younger and younger getting into like working out or muscles like I see eight nine-year-olds now that are talking about their muscles and get and working out which I think that that was different when we were younger I don't think that that was as prevalent but that's because the muscle culture wasn't as prevalent

I think one of the important conversations now for people at home is if you do have someone in your life, maybe it's yourself, but maybe it's like a sibling or a loved one or a friend that you know is struggling, but they might not think they're sick enough. And I say that because I think that's a lot of people that withhold going to get medical help for any reason, because they don't think that they're in dire need or they don't think they're unwell enough. And I don't just say that for eating disorders. I say it for everything.

You know, people stay at home with having a heart attack because they don't think they should go to the doctor. How does somebody help someone in their life when you're at that point? whether it's someone that you love or know or whether it's yourself if you are asking that question for me as a psychiatrist that is always the point to be thinking should I be getting some more info or support about this you know so I think if someone is sitting there feeling like well I definitely don't have anorexia or maybe I don't even have full binge eating disorder but i'm worried about how this element of me worrying about my appearance or this element of my diet

is affecting my mental health just know that that is so valid in terms of that being a significant thing that you can and should seek some support for so i think talking is the biggest thing you know and i think that's what chats like this are about as well it's hopefully people then going and like having a chat about it with their friends and being like do you guys do this or you know is this normal is this normal you know i feel really anxious if i eat before 3 p.m you know it's having these discussions that in and of itself especially at that slightly lower level can really help some of these things start to shift and progress and improve i don't know how i feel about it but there's like i'm watching this show at the moment it's very wildly popular so many people have heard

of it Ginny and Georgia season two it's really good anyway there's a theme in season two about these teenage girls and their two friends discover that they're both suffering from bulimia and at the start when it played out I thought oh this is great that they're covering these themes that obviously affect young girls but then there was another part of me that switched a couple of episodes later and I thought hang on is this perpetuating the idea and showing is it doing more damage than good because I just wonder if it's putting the idea in people's head that might and I've never thought about it. So I don't know what the answer is.

But I found it interesting to think that, okay, they're obviously trying to do something good and raise and make it relatable and raise. Because I haven't seen the end of it. I'm sure it's going to play out where they get help, I imagine. I can't imagine it well now. It's not glorified. Yes, but I did think, hmm, this is probably perpetuating the idea

and planting that seed to people that might not have crossed their minds. But I also think question like your immediate community because sometimes people can reinforce this behavior. You know, if I'd had these conversations in my 20s, my girlfriends at the time would have been like oh my god good for you for having self-control they wouldn't have said this is a problem because they were all doing it themselves you know had one girl that was living off an apple a day like it was like if you could do it the best then you were you know you had the best self-control around it so I think like it's really important to really

assess who is it that you're talking to about this stuff is it reinforcing the behavior or are they holding a mirror up to you and saying like that's not normal you should continue to explore how you know that's not normal definitely you know and it is a double short in terms of especially things on the level of like advertising and tv and things there is that potential element of glorifying things and flagging it in that way in a way but i think with all mental health conditions i think the big thing that i also push is that us asking those questions in that more personal sense to our friends family loved ones it's a bit of a myth in terms of oh my god well if i ask about it maybe i'll make it worse or plant the seed if i ask them if they've self-harmed or if they're thinking of

suicide it's going to make them more likely to do it we have heaps of research now to show that that isn't the case and if you ask about it you are more likely to help that person start to think about it and get support and move it in a positive direction yeah and i think the other thing to add in terms of you know where and how to get help for yourself or get help for someone else it's really really hard it's easier to say than do but booking an appointment with the GP for example like I think even when we think about the GP we think we have to have something really wrong or we have to be quote-unquote sick to be booking an appointment with the GP and especially with mental health stuff you know we don't think about seeing the GP just to ask is this something that's

quote-unquote normal or that I should be worried about and again not all interactions with our GPs and health professionals might be helpful in a sense, but I think it's asking the question if you feel it in yourself. I think that's really interesting, and I'd love to know if it's changed. I think it has changed, but so many people in my life, myself included, I have gone to the GP before, and they told me I was overweight, where they used to do your BMI, which used to be the baseline, your body mass index.

It used to be the baseline for like – Different ways of figuring it out now. Yeah, but it was never accurate. And I remember leaving, they were like, you are technically on the cusp of being overweight because I was very muscly, like I was very fit and I had a lot, I mean, I had a bit of fat too, but I remember leaving that and thinking, fuck, I've got to lose weight. I can't believe I'm overweight. And I remember telling people, like the doctor said my BMI is a bit high.

And I remember people being like, are you crazy? Like, cause I was so fit, but do they still operate off that system? Thankfully, no, not in that same way. And, you know, it's because just as you said, we now thankfully know that BMI is not a gauge of health or necessarily it's, you know, it's measuring other things other than fat mass and all of this stuff. But also, as we've said as well, regardless of how much someone weighs or their BMI category, we absolutely now know that that does not mean they can't still also be really struggling with a significant eating disorder. Even bulimia nervosa, atypical anorexia nervosa is symptoms of anorexia where the person does not have a significantly low weight or BMI. So, you know, there will still be pockets of even within the medical profession where that still needs to shift more. But by and large now, we have come a long way in the medical profession, even with how we talk and think about weight and health and body image and size.

Kieran, before we let you go, there was something that you said before we even started recording that I didn't know and I found it really interesting, also incredibly devastating. In terms of anorexia and when someone's being clinically diagnosed and it is quite severe, what is the mortality rate for someone who is diagnosed with that or recovery rate? So for significant or severe anorexia, we know that anorexia nervosa has the highest mortality rate of any psychiatric disorder and so obviously that's not to scare people but it is to say how significant the things we're talking about are because of any other mental health condition bipolar affective disorder schizophrenia any other condition if someone is diagnosed with

significant anorexia nervosa they are more likely to die from that cause than any other psychiatric cause so it's really really significant and again if we've touched on and talked about this whole way through things not necessarily having to look like that traditional severe end anorexia but of this often being a trickle effect in terms of where things can kind of be pushed and lead to and reinforced and flared we are not just talking about teenage girls you know having some struggles around you know how many carbs they eat or sometimes people can also kind of almost talk about and think about eating disorders in a little bit of a trivialized way but these are really significant and impactful conditions that have a significant mortality rate and that for

anorexia for example are also potentially significantly hard to recover from and for some people they may actually never be able to fully recover so it is about again not making that a scary thing but hopefully making it an inspiring thing in a way to know that catching this and talking about eating disorder and body image dynamics much more at the top of the cliff if we want to use that metaphor is so important for all of us to be thinking about yeah kieran thank you so much for coming and being part of the podcast and i do know that there'll be so many people who listen to this who have had their own experiences whether it's themselves someone they love someone in their family i mean we've all know we've all known someone who's had like

a frightening weight fluctuation and like i think a lot of us don't know what is the best way of approaching that with a friend or a loved one yeah and it's sad to think that we can say that everyone listening knows someone or has an experience like that statistic should not be that high definitely no thank you so much guys and and i guess i just want to i think that's a really like lovely note to leave on as well in terms of to struggle with an eating disorder or to struggle with body image and things it is not necessarily that traditional image that we've kind of all been painted with you can be a professional athlete or a model you can be someone who's you know body image might not actually even look like you struggle with eating or weight related issues

there's no one kind of flavor or way that this presents or looks and so if you are worried about body image or eating or how this is affecting your life or making you feel we should be talking to people about it and getting some support and it's just valid at whatever level it's on so thanks