Planet Lost in the Glare of Binary Stars, illustration by International Gemini Observatory/NOIRLab/NSF/AURA/J. da Silva (Spaceengine)

Disordered Eating and Obesity: Both/And, Not Either/Or

Reject the binary. This cry is a response to simplistic, dichotomous thinking that seems to be ruling the day in so many contexts right now. It’s taking us on quite a number of dead-end journeys. One of these is the false dichotomy that suggests we must choose between providing care for obesity or for disordered eating. But the truth is that our choice should be to care for both.

A new systematic review by Hannah Melville and colleagues makes this point quite well. It appears in the International Journal of Eating Disorders.

85 Studies of Overlapping Obesity and Disordered Eating

Melville’s study was a large meta-analysis of 85 studies (94,295 adults seeking obesity treatment, 76% women; median age 44, BMI 46) found that clinically assessed binge‑eating disorder affects about 14% of patients, while self‑reported moderate to severe binge‑eating spans 26% and 12%, respectively. This highlights a substantial overlap between obesity and disordered eating.

Importantly, this isn’t an either/or scenario. A growing body of evidence underscores that treating obesity and addressing disordered eating or eating disorders aren’t mutually exclusive goals . Many clinicians treat both concurrently through person‑centered, evidence‑based approaches that improve nutrition and body image without exacerbating disordered eating—or vice versa.

Framing obesity care and eating‑disorder treatment as a forced choice is a false dichotomy. Instead, integrated care models exist that do both: reducing weight‑related health risks and mitigating eating‑disorder pathology. The takeaway: we don’t have to choose – we can (and should) address obesity and disordered eating together, tailoring treatment to each person’s needs through compassionate, non‑stigmatizing, science‑driven care. Providing care for both conditions is actually quite important.

And, in fact, other research suggests that better outcomes in both dimensions are possible.

Click here for this excellent new study by Melville et al.

Planet Lost in the Glare of Binary Stars, illustration by International Gemini Observatory/NOIRLab/NSF/AURA/J. da Silva (Spaceengine), licensed under CC BY 4.0

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June 16, 2025

3 Responses to “Disordered Eating and Obesity: Both/And, Not Either/Or”

  1. June 16, 2025 at 7:41 am, John DiTraglia said:

    The cause of disordered eating in normal people is trying to lose weight.

    • June 16, 2025 at 8:56 am, Ted said:

      I would be interested in learning about the evidence for this causal relationship. Do people develop and eating disorder because they try to lose weight? Or do they try to lose weight because they have an eating disorder? Or is it more complex than either of those constructs?

  2. June 17, 2025 at 9:06 am, John DiTraglia said:

    Ted
    By try to lose weight you mean a mental disorder..?
    In our society it’s the consensus that we are too fat and so on and so forth. It’s prima fácil that if you are hungry you are miserable and tend to lose control over yourself etc.
    But there was a psychologist at Drexel U that treated eating disorders by telling his patients to gain some weight. I’ll try to find that. It’s old.