Therapy for difficulties with food and eating in Nottingham

I'm Mandy van Zwam, a psychotherapeutic counsellor, and I offer counselling and psychotherapy for adults whose relationship with food, eating or their body has become a daily struggle, in Beeston, Nottingham, and online across the UK. I have a particular interest in how people relate to food, eating and their bodies, and I'm developing my knowledge in this area. I work alongside medical care, not instead of it.

My private practice opens in 2027. Sessions cost £80 for 50 minutes, in person or online, and we start with a free 20-minute discovery call. Until then, please see your GP, or call Beat's helpline on 0808 801 0677.

Photo to come: A wide, still landscape: the lake at Attenborough at first light

What does an eating difficulty look like?

Not the way it looks in films, most of the time. More often it is quiet and private: rules about what you can and can't eat that nobody else knows about; a running commentary about your body that never stops; eating more than you meant to and hating yourself for it; food that has become the one thing in your life you can control, or the one thing you can't. It can sit alongside a job, a family and a full social life for years. It can also be exhausting in a way that is hard to explain to people who don't have it.

You do not need a diagnosis to talk to me, and you do not need to be "ill enough". If eating takes up more of your head than you want it to, that is reason enough.

What is an eating disorder?

Eating difficulties take many forms: restricting what you eat, bingeing, eating and then trying to undo it, fear of particular foods, or a general sense that food and your body have become the enemy. When a pattern like this becomes severe or long-lasting, a doctor may diagnose an eating disorder, such as anorexia, bulimia or binge eating disorder. Many people never receive a diagnosis. Some are under medical care; some have never spoken to anyone about it; some are well into recovery and want to understand why it happened.

I am still in training, and I work under regular clinical supervision. On our discovery call I will tell you honestly whether I think I am the right person for what you are going through, and if you need more specialised help, I will help you find it.

What if I'm not sure it's a problem?

Most people aren't, at first. Eating difficulties are good at explaining themselves away: it's just being healthy, just being busy, just a phase, just how I am. A useful question is not "is this bad enough?" but "how much room does this take up?" If food, weight or your body are on your mind for a large part of every day, if you plan your life around eating or not eating, if you feel ashamed after meals or avoid eating with other people, then it is taking up room that belongs to the rest of your life. That is worth talking about, whatever we end up calling it.

How does relational therapy help with eating?

Eating difficulties are rarely about food. They are usually about something food has come to stand for: control, comfort, punishment, safety, a way of being looked after or a way of disappearing. In relational therapy we are less interested in the rules and numbers, and more interested in what the eating is doing for you, and what it costs.

My training is in transactional analysis, which pays close attention to the patterns we learned early, often in our families, and to how they play out now. Difficulties with food often have deep roots in how we were fed, praised, watched or ignored. We go carefully. Nobody is asked to give anything up before they are ready.

The relationship between us matters too. Many people with eating difficulties have learned to manage everything alone. Letting someone else see the struggle, and stay, is itself part of the change.

What does therapy with me not do?

I am not a dietitian, a doctor or an NHS eating disorder service, and I don't pretend to be. I don't set meal plans, weigh you, or monitor your physical health. If you need those things, you need them from the right people, and I will say so. Working with me and a dietitian or GP at the same time is a combination that often works well.

What about the people around you?

Eating difficulties are hard on partners, parents and friends too. They often want to help and don't know how, or help in ways that make it worse. Some of our work may be about what you tell the people close to you, what you ask of them, and what you need them to stop doing. I don't see family members in your sessions, and I won't talk to them about you. If someone who loves you needs support of their own, Beat offers it, and I can point them there.

Please see your GP as well

Eating difficulties can harm your body, sometimes seriously, and sometimes without you feeling it. If you have been restricting, purging or bingeing, please see your GP, whatever else you do. They can check that you are physically safe and refer you to the NHS eating disorder service if that is right for you. Therapy with me works best alongside that care, not as a substitute for it. If I am worried about your physical safety, I will tell you, and we will talk about what to do.

Where can I get urgent help?

If you are in immediate danger, call 999 or go to A&E. For urgent but not emergency help, call NHS 111. Beat, the UK eating disorder charity, runs a helpline for anyone affected: 0808 801 0677, and their website has support for you and for the people who love you. Samaritans are on 116 123 at any hour.

What happens if we work together?

My private practice opens in 2027, and you can join the waitlist now. When a place comes up, we start with a free 20-minute discovery call. If we go ahead, we meet weekly for 50 minutes, in person in Beeston or online. Early sessions are about understanding what is going on, in your words. From there the work follows you. Some people want to talk about food a great deal; others barely mention it for weeks, and that is fine too. There is no set programme and no timetable for getting better.

You can read more about me and my training, or see common questions about sessions, cost and confidentiality.

I work under regular clinical supervision, which means that another experienced therapist helps me think about my work, without knowing who you are. For this kind of work in particular, I would not do it any other way.

Common questions

Do I have to talk about what I eat?

Only if you want to. Some people find it a relief to say it out loud for the first time; others need months before they can. Both are fine.

Will you make me gain or lose weight?

No. I am not a medical service and I don't set targets. If your GP or a dietitian has, we can talk about how that feels.

I've had an eating disorder for years. Is it too late?

No. People recover after decades. Long-standing patterns take longer to shift, and they do shift.

Do you work with men, and with older people?

Yes to both. Eating difficulties are not only a young woman's problem, though they are often described as one, and men and older adults tend to wait longer before asking for help because of it. You are welcome here at any adult age.

What if the person struggling is under 18?

I work with adults only, 18 and over. If you are worried about a child or teenager, start with their GP, who can refer them to the NHS eating disorder team for children and young people in Nottinghamshire. Beat supports parents and carers too.

What if I am also being seen by the NHS?

That can work well, as long as everyone knows. I will ask your permission to let your NHS team know we are working together, so that we are not pulling in different directions.

Can we work on this in Dutch?

Yes. For many people the words for this live in their first language. More on therapy in Dutch.

Where I see clients in and around Nottingham

In person at Highfields Therapy in Beeston (NG9), a short tram, train or bus ride from Chilwell, Attenborough, Bramcote, Stapleford, Wollaton, Lenton and West Bridgford. Online by video anywhere in the UK.