Frequently Asked Questions

I work with all eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID (avoidant/restrictive food intake disorder), and other specified feeding or eating disorders (OSFED).

I also work with disordered eating patterns that may not meet full diagnostic criteria but are causing significant distress or impacting your quality of life.

Eating disorder treatment focuses on recovery from a serious mental illness, not weight loss.

For anorexia or bulimia, weight is monitored for safety, not as a goal, and GLP-1 medications are not appropriate. For binge eating disorder, while there is some early research exploring whether GLP-1 medications might help reduce binge episodes, this is about addressing the eating disorder itself, not about weight loss.

Any consideration of medication would be part of a comprehensive treatment approach focused on your recovery and your relationship with food.

What matters is an honest assessment of your situation and the right support for you.

Yes. Many people are unsure where they fall on the spectrum from normal eating to a clinical eating disorder.

I can help you understand your patterns, assess whether they meet criteria for a diagnosis, and recommend the most appropriate support.

There is no judgement either way. What matters is that you get the right help for your situation.

For anorexia nervosa, GLP-1 medications are dangerous and absolutely contraindicated. They can enable restriction, mask nutritional needs, and be life-threatening.

For bulimia nervosa, the evidence is limited and concerning.

For binge eating disorder, there is some early research into whether these medications might help reduce binge episodes, but this is very much in its early stages and would only ever be considered as part of comprehensive eating disorder treatment, not as a weight loss intervention.

Anyone with a current or past eating disorder must be completely honest with their prescriber. Your life is more important than weight loss.

Through Altum Health, we provide eating disorder treatment for adolescents, young people, and adults.

For individual work with me directly, please get in touch to discuss your situation. If I am not the right fit, I can help point you towards appropriate services.

No. I do not prescribe medication.

I am a psychologist, not a medical doctor.

I am a consultant psychologist for Slimmr, and if you need medical assessment, prescribing, dose changes, or clinical monitoring, this is handled by their prescribing team.

GLP-1 medications are effective at reducing appetite and quieting "food noise," but they do not address why you developed an unhealthy relationship with food in the first place.

Research shows that without psychological and behavioural support, people are projected to regain all their weight loss within 1.5 to 2 years of stopping medication, at a rate four times faster than after traditional approaches. This is because the underlying psychological patterns remain untouched.

I help you use the window of reduced appetite to build new skills: understanding your eating triggers, managing emotions without food, developing body acceptance, and creating sustainable routines.

The medication gives you the quiet; what you build in that quiet determines whether your changes last.

Your prescriber manages all medical aspects of your treatment, including dosing, blood tests, and monitoring for side effects.

This might be your NHS GP, a private weight management clinic, or the prescribing team at Slimmr.

I work alongside your prescriber to provide the psychological component of your care, but I do not have access to your medical records or make decisions about your medication.

No. While much of my work focuses on supporting people using these medications, the psychological principles apply to anyone wanting to change their relationship with food.

You might be considering medication but not yet started, you might have decided medication is not for you, or you might have finished your course and want support maintaining your progress.

I also work with people considering, preparing for, or recovering from bariatric surgery, as well as those who simply want help with emotional eating, body image, or disordered eating patterns.

This depends on your current situation.

If you have an active eating disorder, particularly anorexia nervosa or bulimia nervosa, GLP-1 medications can be dangerous, and weight management support is not appropriate. You would need specialist eating disorder treatment first, which I also offer.

If you have a history of an eating disorder but are now recovered and stable, we can discuss whether GLP-1 psychological support is suitable for you.

For people with binge eating disorder, there is early evidence that GLP-1 medications combined with psychological support may be helpful.

I assess each person individually and will be honest about what is and is not appropriate for your situation.

This is an informal conversation for us to see if we are a good fit.

You will speak with me or a senior colleague.

You can tell us a bit about your situation and what you are hoping for, ask any questions you have, and get a sense of how we work.

We will be honest about whether we think we can help and, if not, we will try to point you in the right direction.

There is no obligation to book further sessions.

It means my approach is grounded in clinical experience and evidence-based practice, not diet culture or wellness trends.

I have 25 years of experience across NHS and private practice, specialising in eating disorders and weight management.

I understand the complex psychology of eating behaviour, the neuroscience of appetite and reward, and the research on what actually works for sustainable change.

I also understand what can go wrong, which is why I screen carefully for eating disorders and prioritise your psychological safety alongside your weight management goals.

Sessions are typically 50 minutes long and take place weekly or fortnightly, depending on your needs and preferences.

We work through key areas, including understanding your eating patterns, managing emotional eating, body image work, building sustainable habits, and preparing for life after medication or surgery.

The structure is flexible and tailored to you.

Some people need focused work on one particular area; others benefit from working through a more comprehensive programme.

This varies considerably.

Some people find that 6 to 8 sessions give them the tools they need. Others benefit from longer-term support, particularly if they are working through deeper patterns around food and body image or want ongoing support through the process of tapering off medication.

We will review progress regularly and you are always in control of how long we work together.

Yes, this is very common.

The medication reduces physical hunger and cravings, but it does not automatically change the psychological patterns that developed over years or decades.

You might find yourself eating less but still feeling anxious about food, still thinking about it constantly, or still turning to food when emotions are difficult.

This is exactly what psychological support addresses. We work on the relationship with food that sits underneath the appetite changes.

Absolutely.

This fear is understandable given the statistics on weight regain, and it is one of the most common concerns I work with.

We focus on building the skills, habits, and psychological resilience you need before you start tapering.

We also work on the fear itself, which can become paralysing if left unaddressed.

The goal is for you to feel genuinely prepared and confident, not just hopeful, when you reduce or stop medication.

Decisions about medication timing and dosing are medical decisions that should be made with your prescriber.

However, I can help you think through the psychological readiness questions:

• Have you done the internal work?
• Are your new habits feeling stable?
• Do you have strategies for managing difficult emotions without food?

I can also support you through the tapering process itself, which can bring up anxiety and require adjustment to your coping strategies.

I work with people at all stages of their weight management journey, including those considering, preparing for, or recovering from bariatric surgery.

The psychological aspects are similar:

• understanding your relationship with food
• managing emotional eating
• adjusting to body changes
• and building sustainable habits.

Psychological preparation before surgery can be valuable, and if you have already had surgery and are struggling, support is available.

The same principles apply: surgery changes your body, but it does not automatically change your mind.

Yes, and I encourage this.

With your consent, I am happy to communicate with other professionals involved in your care.

Integrated support often produces better outcomes than working in silos.

If your prescriber or GP has specific concerns they would like me to address, or if it would be helpful for me to share relevant information with them, we can arrange this.

Contact your prescriber or GP.

I am not able to advise on medical issues, including side effects of medication.

If something feels urgent, contact NHS 111 or seek emergency care.

In our sessions, we can discuss the psychological impact of side effects and how to manage any anxiety or frustration they cause, but the medical management is your prescriber's role.

Please get in touch for current fee information. I am happy to discuss this during your free 20-minute consultation.

Yes.

I follow strict professional confidentiality guidelines as required by my registration with the Health and Care Professions Council (HCPC).

What you share in sessions stays between us, with very limited exceptions required by law (such as safeguarding concerns or court orders).

If I need to share information with other professionals involved in your care, I will always discuss this with you first and seek your consent.

No, it is not required.

The book provides a comprehensive self-guided programme that many people will find valuable, but working with me one-to-one is different.

We tailor the work to your specific situation, go at your pace, and address your individual patterns and needs.

That said, if you have read the book, it can provide helpful shared language and framework for our sessions.

Book a free 20-minute consultation through my website. This gives us a chance to talk through your situation, answer any questions, and see if we are a good fit. There is no obligation and no pressure. If we decide to work together, we will match you with the most appropriate clinician and arrange your first full session from there.