Understanding Therapy for Eating Disorders
If you’re thinking about therapy and struggling with food and body image, you’re in the right place. Sometimes, just knowing what to expect or what questions to ask can take the edge off that overwhelmed feeling and make it easier to take the first step. While every therapist is different, and you don’t need to have all the answers before you begin, having some basic info can be really helpful. That’s why I’ve put together this guide to give you a little more clarity.
That said, the most important thing when choosing an eating disorder therapist is the connection you feel with them. So, as much as information is useful, trust your instincts when it comes to finding the right fit!
In this article, I’ll walk you through what therapy for eating disorders looks like, who it affects, and why people might be experiencing an eating disorder. Think of this as your go-to guide to help you feel more informed and a little less alone as you navigate this process. Let’s dive in!
What Is an Eating Disorder?
Eating disorders are a complex mental health condition that can be very serious. They’re not just about food but also the difficult thoughts and feelings people have about their bodies and weight. These struggles can significantly impact every part of life, physically, emotionally, and socially.
If you think you might be struggling with an eating disorder or disordered eating, you might find yourself constantly preoccupied with food, your body, or your weight. It can feel like an obsession that’s always on your mind. You may even feel like you can’t be present in the moment or enjoy life because your thoughts are consumed by these concerns. This can lead to intense feelings of shame and guilt.
And What is Disordered Eating?
Disordered eating refers to a range of eating behaviors that may not meet the full criteria for an eating disorder but are still harmful, and cause real distress. It can include things like skipping meals regularly, extreme dieting, or constantly feeling guilty after eating.
While the distinction is certainly not always important, it can be helpful to understand that all of these types of issues, whether you fit into a specific one or not, can be distressing, and more support can be beneficial.
What Are Some Different Kinds of Eating Disorders?
Anorexia: Anorexia is characterized by extreme food restriction, an intense fear of gaining weight, and often a distorted perception of one’s body shape, weight, and size.
Bulimia: Bulimia involves cycles of binge eating followed by behaviors aimed at preventing weight gain, such as vomiting (purging), excessive exercise, or using laxatives.
Binge Eating Disorder (BED): People with BED experience regular episodes of eating large amounts of food—much more than others would typically consume in the same timeframe. This often leads to feelings of being out of control, followed by intense shame and guilt.
Other Specified Feeding or Eating Disorder (OSFED): OSFED is a category for eating disorders that don’t fit neatly into the specific definitions of other eating disorder diagnoses but still cause significant distress or impairment.
Why Do People Get Eating Disorders?
Eating disorders are complex, and their origins aren’t always as simple as concerns about physical appearance. While societal pressures around body image can certainly play a role, many other factors often contribute to the development of an eating disorder. Some of the reasons why people may struggle with eating behaviors include:
Emotional Trauma and the Body’s Response
Our bodies hold on to emotional trauma in ways that can be difficult to process or understand. People often navigate the emotional impact of their past experiences through behaviors like food restriction, binge eating, or purging. The act of controlling food may serve as an attempt to regain control over the overwhelming feelings that stem from past trauma. In this sense, the eating disorder becomes a coping mechanism, a way to manage emotional pain or avoid confronting uncomfortable feelings.
Microaggressions and Social Pressure
Microaggressions, or subtle slights and insults, can also contribute to eating disorders. For people who experience constant negative comments about their appearance, their weight, or their eating habits, these microaggressions can erode self-esteem and reinforce the desire to alter one’s body. In particular, people who experience discrimination or marginalization may use food as a way to exert control over their environment when they feel powerless or rejected.
Coping with Anxiety and Depression
For many, eating disorders develop as a way to cope with anxiety or depression. The repetitive actions of food restriction or binge eating may provide a temporary sense of relief from overwhelming emotions. When life feels out of control or when a person feels emotionally numb, controlling food intake can be a way to regain a sense of agency or to distract from other painful emotions. In some cases, individuals may experience a brief sense of comfort or distraction during an episode, reinforcing the behavior.
Navigating Gender and Sexual Identity
For queer and transgender individuals, eating disorders can become a way of coping with the stress of navigating one’s gender or sexual identity. For someone coming out or grappling with the decision of whether or not to come out, the pressure to conform to societal norms around appearance and gender expression can be overwhelming. Eating disorders can become a way to mitigate feelings of inadequacy or to feel “enough” within a world that may not always validate their identities. Additionally, for those who experience ambivalence about being androgynous or nonbinary, food may serve as a way to manage complex emotions about self-image and belonging.
Eating disorders are multi-faceted and are often deeply tied to a person’s emotional, psychological, and social experiences. While there are many pathways to developing these behaviors, it’s essential to remember that eating disorders are not about “willpower” or simple vanity—they are complex responses to a range of factors, from trauma to the pressures of navigating gender and identity.
Who Gets Eating Disorders?
We often hear about young, white, cisgender women with eating disorders, but by no means is this the only demographic that is impacted. Eating disorders don’t discriminate. They can affect anyone, regardless of age, gender, race, or background. However, certain groups are at a higher risk, often due to unique pressures, societal expectations, and personal challenges.
Research shows that LGBTQIA+ individuals are disproportionately affected by eating disorders, experiencing disordered eating behaviors at significantly higher rates than their cisgender heterosexual counterparts (Lacie L. Parker and Jennifer A. Harriger 2020). Here are some of the key reasons why eating disorders may be more prevalent in these communities:
LGBTQIA+ individuals face unique pressures related to gender norms, discrimination, body image, and societal beauty standards, which can contribute to the development of eating disorders as a way to cope with stress, align with gender expectations, or navigate challenges like limited access to gender-affirming care.
Why Therapy for Eating Disorders Can Be So Helpful
Eating disorders are complex, but they don’t have to define your life forever. Therapy offers a space to explore how your eating struggles show up in your life presently and the underlying causes of them, as well as develop more harmonious ways of relating to food, your body, and yourself.
Therapy provides a safe, non-judgmental environment where you can work through these layered feelings and find ways to move away from them so they don’t feel so abrasive.
You don’t have to face this alone. With the right support from an eating disorder therapist, therapy can help you shift how you feel and start living a life where eating struggles don’t control you.
What Are Different Approaches Therapists Use for Eating Disorder Therapy?
When it comes to treating eating disorders, there isn't a one-size-fits-all approach. Each person’s experience is unique, and the most effective therapy will depend on individual needs, circumstances, and goals. Some therapeutic approaches that can be helpful are:
Trauma-Informed Care
Many eating disorders are linked to past trauma. A trauma-informed approach creates a safe space to unpack those experiences without judgment. Approaches like EMDR (Eye Movement Desensitization and Reprocessing) can help reprocess hard memories that are contributing to current struggles so they don’t feel so close and intense.
Gender-Affirming Therapy
For anyone who’s queer, trans, nonbinary, or gender expansive, working with a gender-affirming therapist can be incredibly beneficial. Gender-affirming therapy ensures you’re seen and validated for who you are without having to justify your identity. It’s a space where you can simply be yourself without emotional labor or judgment.
Health at Every Size Aligned (HAES)
A therapist who is “Health at Every Size (HAES) aligned” focuses on your overall well-being and mental health, no matter your body size. They steer clear of promoting negative body image or weight-related stigma and instead encourage body acceptance and self-compassion.
Harm Reduction
Harm reduction is about making progress without expecting perfection. In the context of eating disorders, it means acknowledging where you’re at and reducing the harm caused by disordered eating behaviors. It’s not about quitting everything overnight—it’s about taking small steps that feel doable and building trust as you go.
Behavioral Therapy Techniques
Behavioral therapy approaches, such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), are powerful tools for addressing eating disorders. CBT helps you identify and challenge the negative thoughts and behaviors that fuel disordered eating. It provides practical strategies to manage triggers, make healthier choices, and develop more balanced eating habits that support your emotional and physical well-being.
DBT, on the other hand, focuses on building emotional regulation skills and tolerance for distress, which are helpful when navigating the ups and downs of recovery. It helps you cope with difficult emotions without turning to disordered eating behaviors for relief. DBT also emphasizes mindfulness, which helps you stay present and grounded, making it easier to engage in healthier coping mechanisms.
These are just a few of the many approaches different therapists take. While understanding them can be helpful, working with a therapist you like and feel connected to is always at the heart of the work.
In Closing
If reading this resonates with you, you’re not alone. Eating disorders are tough to navigate, but therapy can offer a path to healing and understanding. It’s all about creating a space where you can unpack the complex layers of your experiences, explore the root causes, and develop kinder, more balanced relationships with food, your body, and yourself.
If you’re ready to take the first step, whether you’re looking for support for yourself or someone else, therapy can be an invaluable resource. Healing isn’t linear, but with the right tools and support, it is absolutely possible.
Remember, finding the right therapist can make all the difference. Trust your instincts, ask questions, and don’t be afraid to take your time finding someone who truly understands your needs. You’re worthy of help, and you don’t have to do this alone.
Reach out today to start a conversation. Therapy can be the first step toward feeling more empowered, more in control, and more at peace with yourself.
You deserve to feel better. Take that first step today and reach out to Therapy With Lizzie.
Create a New Relationship With Your Body With Therapy for Eating Disorders in Burlington, VT
Are you ready to start healing your relationship with food, body image, and yourself? Therapy for eating disorders is a powerful first step toward creating lasting change. At Therapy With Lizzie, I’m here to walk alongside you in this process, offering compassionate and personalized support. Let’s take this step together. It’s simple to get started:
Reach out to schedule a free consultation.
Meet with me, Lizzie Werner-Gavrin, an experienced therapist specializing in eating disorders.
Cultivate a more compassionate relationship with your body.
You don’t have to navigate this alone. Let’s start this journey together. You deserve to feel empowered, understood, and at peace with yourself. Reach out today, and let’s take that first step toward healing!
Additional Online Services I Provide Throughout Vermont
Along with supporting adults facing body image challenges and eating disorders with therapy for eating disorders, I offer EMDR therapy to help process trauma and emotional pain. My work also includes guiding individuals through anxiety, stress management, and building resilience. I provide a compassionate, affirming space for adults exploring their gender and sexuality. Whether you’re navigating past trauma, managing anxiety, or discovering your identity, I’m here to walk with you through every part of your journey with understanding and support.
