Fats and BED I think that BED is seriously underdiagnosed and under treated. How can someone look at an Obese person and think "they have a healthy relationship with food"?  Overweight I can see how it happens - people are unaware of the nutritional status of food.over eat by a couple hundred calories a day (alcohol etc ) and you'll be overweight quickly. People who become Obese and death fat are using food as a drug. They eat until they are killing themselves and keep eating. They manipulate loved ones into continuing to feed their addiction when they are unable to get it for themselves  No one can get to obesity or morbid obesity with a healthy relationship with food.  When you tell them they might have BED they will be angry, embarrassed,  ashamed, and deny it.  I responded that way to being told I was sick, and had an ED that would kill me. However it lead to treatment.  Fat acceptance stops short of allowing that interaction because it's uncomfortable . Also our culture is one in which binging is normalized.  It's 'normal ' to eat too much, maybe semi regularly. It's a TV trope - sadness eating, celebratory eating, the skinny person who eats so much. Elastic waistband jokes about thanksgiving. An entire holiday about eating. Why is it normal to eat yourself into a coma? Why is it only ok to be thin if you tack on a sympathetic narrative?  "My tiny boobs! I can't gain weight! " or if you claim to eat way too much food. Binge eating is normal, except that it isn't. It isn't okay to sometimes starve or purge. A disorder is an unhealthy psychological relationship with food that leads to physical health consequences. If you eat yourself to the very limit of physical capacity,  you don't have a healthy relationship with food. You have a problem.