When eating behaviours fall outside diagnostic criteria
In clinical practice, we often see eating behaviours that don’t fit the diagnostic criteria for an eating disorder, yet still cause significant distress. These patterns can be easy to overlook or minimise, particularly when they don’t present as “textbook” cases. However, they offer an important opportunity for practitioners to look beyond food itself and explore the emotional landscape that may be driving the behaviour.
As nutritionists, it can be tempting to focus on dietary intake, portion control, or strategies to improve willpower and motivation. These tools absolutely have their place. But when food behaviours are being used to meet an emotional need, nutritional strategies alone may only scratch the surface.
Looking beyond food: a case example
I recently worked with a mid-life client who presented with what she described as “ad hoc out of control eating”. Importantly, her experience did not meet the clinical criteria for binge eating disorder. Her eating patterns were largely stable and balanced when her family members were at home. However, when she found herself alone in the house, she reported feeling dysregulated and engaging in episodes of excessive eating.
At first glance, this could easily be framed as a behavioural or environmental issue. However, a deeper exploration revealed something more nuanced.
Understanding the emotional driver
Through a food counselling approach, we shifted the focus away from “fixing” the eating and instead explored what the eating might be doing for her. She described a powerful internal experience: a feeling of emptiness that seemed to need filling. Notably, she recognised that no amount of food could satisfy this feeling. Even more interesting was that this experience only emerged when she was home alone.
This became a key therapeutic entry point.
As we gently unpacked this experience, the client began to connect these feelings with earlier life experiences, particularly a sense of abandonment and relational strain in her earlier years. Being alone in the home appeared to activate this unresolved emotional state, with food serving as a temporary attempt to soothe that internal discomfort.
Working within scope of practice
This is where scope of practice becomes especially important. As practitioners, recognising when food is being used as an emotional regulator allows us to either work within our training or refer appropriately. In my case, as both a qualified counsellor and nutritionist, I was able to integrate therapeutic support alongside nutritional guidance.
In clinical practice, we often see eating behaviours that don’t fit the diagnostic criteria for an eating disorder, yet still cause significant distress. These patterns can be easy to overlook or minimise, particularly when they don’t present as “textbook” cases. However, they offer an important opportunity for practitioners to look beyond food itself and explore the emotional landscape that may be driving the behaviour.
As nutritionists, it can be tempting to focus on dietary intake, portion control, or strategies to improve willpower and motivation. These tools absolutely have their place. But when food behaviours are being used to meet an emotional need, nutritional strategies alone may only scratch the surface.
Looking beyond food: a case example
I recently worked with a mid-life client who presented with what she described as “ad hoc out of control eating”. Importantly, her experience did not meet the clinical criteria for binge eating disorder. Her eating patterns were largely stable and balanced when her family members were at home. However, when she found herself alone in the house, she reported feeling dysregulated and engaging in episodes of excessive eating.
At first glance, this could easily be framed as a behavioural or environmental issue. However, a deeper exploration revealed something more nuanced.
Understanding the emotional driver
Through a food counselling approach, we shifted the focus away from “fixing” the eating and instead explored what the eating might be doing for her. She described a powerful internal experience: a feeling of emptiness that seemed to need filling. Notably, she recognised that no amount of food could satisfy this feeling. Even more interesting was that this experience only emerged when she was home alone.
This became a key therapeutic entry point.
As we gently unpacked this experience, the client began to connect these feelings with earlier life experiences, particularly a sense of abandonment and relational strain in her earlier years. Being alone in the home appeared to activate this unresolved emotional state, with food serving as a temporary attempt to soothe that internal discomfort.
Working within scope of practice
This is where scope of practice becomes especially important. As practitioners, recognising when food is being used as an emotional regulator allows us to either work within our training or refer appropriately. In my case, as both a qualified counsellor and nutritionist, I was able to integrate therapeutic support alongside nutritional guidance.