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Session 7

Body Image and Healthy Eating

Session 7

Breaking free from diet culture

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Normal eating or disordered eating?

Drag and drop the sentences into the correct bubble below...

Disordered eating

    This is correct

    Normal eating

      Incorrect! Try again

      Do you think the statements below are normal eating or disordered eating?

      Drag the sentences into the correct bubble

      Sometimes overeating and sometimes undereating

      Avoiding whole food groups due to food rules (all carbs are 'bad')

      Food and weight occupying most of your waking thoughts

      Allowing food to have moral value (eating a specific food makes you a bad person)

      Measuring and weighing food

      Choosing desired foods without guilt

      Eating regular balanced meals and snacks of normal portion (e.g. 3 larger meals and small snack or multiple smaller snacks)

      Meeting nutritional needs through varied diet

      Ignoring your body's hunger signals

      Being able to maintain a healthy body through regular and relaxed intake


      What does 'normal'
      eating look

      social foods.

      Includes having
      varied food

      Variable in the
      amount and type.

      Usually comprises of
      3 main meals
      and 2-3 snacks, however,
      this can vary based
      on many factors
      e.g. how active
      you are, your appetite,
      the environment


      Listening to hunger
      and fullness cues.
      Eating regularly is
      the best way to
      manage appetite.

      Enjoying your food.

      fast food or

      Using some
      restraint in your
      food selection
      to get the right
      of foods.

      What affects our ability
      to eat 'normally'?

      Take a moment to list some ideas:

      What we read on social
      media, magazines and the internet.

      The eating habits
      observed or learnt
      from childhood.

      Pressures from
      peers and society
      to look a certain

      Our knowledge of food and
      what normal eating
      behaviours are.

      The diet culture
      we live in.

      Diet culture

      A system that values weight, shape and size over health and well-being!

      What does diet culture mean to you?


      Ignoring body

      worth with
      how you look

      Equating thinness
      with health

      worth with what
      you eat

      Food rules

      Food anxiety

      Avoiding foods
      too high in fats,
      carbs or calories

      Food label gives
      you permission
      to eat

      Eliminating food

      Food guilt

      Examples of
      diet culture!

      because of food

      Feeling or need
      to justify eating

      Exercise for

      Diet talk

      weight loss

      Scale dictates
      happiness or

      Believing you must
      take supplements
      for health

      What causes and maintains diet culture?

      The way we speak >>

      It's my cheat day!

      This is so bad for you.

      I start my new diet tomorrow.

      What influences diet culture?

      The UK diet industry is worth $2 billion a year

      Competition and comparison

      Things to bear in mind...

      Anyone can call themselves a "nutritionist".

      It is not a legally protected title – an Instagram “nutritionist guru" may have no qualification.

      Research reveals social media influencers give bad diet and fitness advice.

      Breaking food rules

      Stop comparing your food choices to someone else’s.


      It’s okay if you eat more than someone else, man or woman!

      Do you have any rules around how you eat or the foods you eat?

      Do you have any deliberately avoided foods?

      Make some notes below...

      Most days

      Eats a mix of both.

      Also no food rules

      Having grapes for dessert because it’s what you want.

      Some days

      Eats mostly processed foods.

      Other days

      Eats mostly 'whole' foods.

      Most days

      Eats a mix of both.


      Not physically hungry but have a craving for some chocolate.


      Totally okay, eat mindfully to identify satisfaction and enjoy without guilt!

      Using your list of rules and avoided foods. Cut these up into individual pieces of paper and fold to place in a jar.

      Choose one or more out of the jar to challenge each week.

      You can challenge that rule as frequently as daily or as little as once in the week.

      Challenging food rules
      and avoided foods

      Consider where this rule came from:

      Is it based on evidence and a credible source?

      Is it relevant to your age group?

      Is it relevant to your gender?

      Is it designed for a healthy population or for medical purposes?

      Consider the impact of the rules or avoided foods
      on other parts of your life:

      Does this rule or avoided food stop you from being able to do social activities?

      Does it stop you attending social events?

      Does it impact your mood negatively?

      Does it negatively impact your physical health? Such as, fatigue, illness,
      dizziness, weight, energy levels etc.

      Note: It will likely take more than one attempt, so consider placing them back in the jar for another attempt.

      The harm of diet culture

      Harmful to health

      Normalises disordered eating

      Dominates your thoughts

      Promotes eating disorders

      Steals joy from life

      Waste of time

      Waste of money

      Increases guilt and shame

      Makes digestion worse

      Increases risk of physically ill health

      Hurts relationships

      Exercise becomes punishment

      What are your take home messages about diet culture?

      Why diets don’t work

      Diets are usually short term interventions focused on rigid, strict and restricting food plans with the aim
      of losing weight.

      Physiological and psychological effects:
      - Diets are often overly prescriptive in the deficit of intake that leads to semi-starving of the body and physical body feeling deprived. Physiologically and psychologically, the body starts to increase it’s signalling to get what it needs… food.

      - Young people may feel like they are constantly thinking about food, preoccupied by making food choices or have a building sense of craving food.

      - This deprivation of brain and body can lead to overconsumption of food intake and poor food choices, which can undo the aims of the initial diet.

      - Following overconsumption, young people may then feel guilty about eating too much and feel a need to restrict further to make up for the overeating. This leads to a vicious cycle.

      Creation of food rules:
      - Diets usually promote labelling foods into categories of 'good foods' and 'bad foods'.

      - Psychologically, this can lead to over restriction of the 'bad foods' and significant guilt if a young person gives in and eats a 'bad food'. Eating a bad food or banned food, can make a young person feel like they have failed in their diet.

      - This can trigger thoughts that they might as well eat as much as they can since they failed anyway, with a view of then going back to denying themselves the food in the future.

      Diet culture influence

      Diets are usually short term interventions focused on rigid, strict and restricting food plans with the aim
      of losing weight.

      In the body image sessions, one task was to complete two self-worth pie charts. One chart focused on aspects currently
      highlighted as influencing your self-worth, and the second pie chart focused on how you would like your future self-worth pie chart to look (based on goals, values, beliefs and desires).

      In a blank pie chart, draw out how much space dieting, or controlling what you eat and how you look takes up.

      Are there other aspects of your life that have been neglected due to your focus on diet and image?

      How would you like your pie chart to look in regard to what you hold important?

      Some ideas...

      Build awareness

      Begin to notice the messages around you that are from diet culture. This includes conversations about weight, body shape and dieting.

      Know the facts

      Recognise the unhelpfulness of diet culture. Know that skinny doesn’t always equal healthy. Remember why fats and sugars are ok, and even needed, in our diets.

      Walk away from diet culture

      When you see it say “no not today” to diet culture.

      It’s ok to leave these conversations – or even call them out! Talk about something else.

      Do something else – engage in hobbies, voluntary work or learning something new.

      Surround yourself with anti-diet culture messages

      Listen to podcasts and follow social media around intuitive eating and body kindness.

      Find friends that have similar beliefs to you.

      Empower others to break free of diet culture.

      Create a diet culture free zone

      Clean up your social media feeds.

      Avoid diet products – food and drinks, supplements, books and magazines.

      A healthy relationship to food is not based on a restrictive diet.

      You are awesome as you are!

      Don't go on a diet.

      Superfoods don’t exist.

      All food is neutral.

      Challenging diet culture

      How can we challenge diet culture?

      Can you think of a good magazine or news headline to challenge diet culture?

      My worth is unrelated to how I look!

      Know our boundaries...

      It’s ok to say no and prioritise mental health.

      Feel amazing...

      Stop comparing yourself to unrealistic standards.

      Move because it feels good in your body and head but don’t forget to rest!

      Don't exhaust yourself just to get visible abs!

      Try to choose what you genuinely want.
      Think about how hungry you are, and remember some of the mindful eating and intuitive eating ideas discussed in the previous presentation.

      Try not to order based on any food rules
      you have or diet culture influences.


      Ordering off a menu

      What would you like to order today?

      The pad Thai because
      they like the cuisine and
      peanut taste.


      What did you order and why?

      Examples from other young people:

      The quesadilla
      because they love

      The souvlaki because it
      reminded them of a
      holiday in Greece.



      Acknowledgements Body Image & Eating

      Content created by:

      • Module Lead: Dr Erica Cini - Consultant Child and Adolescent Psychiatrist ELFT
      • Module Team:
        Alex Bell - Senior Specialist Paediatric Dietitian
        Emily Bland - Assistant Psychologist
        Elliott Lee - Assistant Dietitian
        Phoebe Bainbridge - Assistant Psychologist
      • East London NHS Foundation Trust Community Eating Disorder Services (CEDS) and Eating Disorder Services (EDS)

      The CEDS Body Image and Normal Eating Group is a CBT psychoeducation series of sessions based on the manual developed by Hampshire CEDS, consultation and published body image manuals (Fairburn, 2001; Collins-Donnelly, 2014) such as Cognitive Behaviour Therapy and Eating disorders and Banish Your Body Image Thief.

      Meisel, Georgia & Chounkaria, Michelle & Cini, Erica. (2021). The Development of a Body Image and Normal Eating Group for Adolescents in an Eating Disorders Service. 10.13140/RG.2.2.29915.28965.

      Wilson, Ruth & Iredale, Catherine & Fialko, Laura & Rumball, Katrina & Cini,Erica. (2018). Group Interventions in an Eating Disorder Service for Children & Young People: Development of a ‘Learning to Live in Your Body’ Group.10.13140/RG.2.2.32896.12807.

      Image references available upon request, stock images provided by Adobe stock images, Shutterstock and Freepik. For any copyright questions or concerns please contact our web development service provider Infused Media Ltd.

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      References or Creators Credit


      My Notes

      Supporting Videos

      The Fight, Flight, Freeze Response

      If you could change one thing about your body, what would it be?

      Mindful Eating