Therapy for Eating Disorders and Negative Body Image

Yes, therapy is incredibly helpful for eating disorders, and there are many different approaches, such as EMDR, that therapists use. While some therapists specialize in one specific method, many, myself included, integrate several approaches to best support each individual client.

Eating disorders are complex and multifaceted. Because of this, effective treatment usually involves a combination of therapeutic approaches. At my practice, I draw on several evidence-based therapies to offer a holistic, personalized treatment plan that supports clients at every stage of their healing journey. Each approach addresses different aspects of an eating disorder, whether it’s trauma, body image, emotions, or behaviors. Below are some of the key therapeutic modalities I use to support my clients.

Trauma-Informed Therapy

For many individuals, eating disorders are deeply intertwined with past trauma. Whether it’s childhood abuse, neglect, bullying, or other traumatic experiences, unresolved trauma can contribute significantly to disordered eating behaviors. Trauma-informed therapy is essential for those whose eating struggles are connected to these past experiences. This therapy focuses on creating a safe, trusting, and supportive environment where clients feel empowered to explore and process their trauma without feeling overwhelmed or re-traumatized. By addressing the root causes of trauma, clients can begin to heal their relationship with food, body image, and emotions in a way that fosters long-term recovery.

The foundation of trauma-informed therapy is building safety and trust, recognizing that trauma can affect every aspect of a person’s life. When clients feel safe, they are better able to reconnect with their bodies and emotions, which is crucial in healing from eating disorders.

Narrative Therapy

Narrative therapy offers a unique perspective by helping clients view their eating disorders as separate from themselves. This therapeutic approach emphasizes the power of storytelling and reframing, allowing clients to understand themselves in new ways to support clients moving out of that stuck feeling and gaining a sense of empowerment and distance from the behaviors that have controlled their lives.

Through narrative therapy, clients can start to rewrite their story, gaining clarity about how their eating disorder developed and how it no longer defines them. This process allows individuals to challenge the beliefs and patterns that contribute to their disordered eating, helping them build a new identity—one that’s grounded in self-acceptance and compassion.

Somatic Therapy

For many people with eating disorders, there is a significant disconnect between their mind and body. Somatic therapy addresses this mind-body disconnect by helping clients become more aware of their physical sensations and emotional responses. By focusing on the body through techniques like breathwork, body awareness exercises, and gentle movement, somatic therapy helps clients reconnect with their bodies in a way that promotes healing and self-compassion.

Somatic therapy is especially effective for those who feel numb, dissociated, or uncomfortable in their bodies due to their eating disorder. It offers a non-verbal, experiential approach to healing, encouraging clients to tune into their physical sensations as a way to better understand and regulate their emotions, behaviors, and thought patterns.

EMDR (Eye Movement Desensitization and Reprocessing)

EMDR is a powerful therapeutic technique designed to help clients process past trauma that may be contributing to their eating disorder. By using bilateral stimulation—such as eye movements, tapping, or auditory tones—EMDR helps to reduce emotional distress associated with traumatic memories. This process allows the brain to reprocess memories in a way that makes them less emotionally charged, supporting clients in developing new beliefs about themselves.

EMDR can be particularly helpful for individuals whose eating disorders are linked to unresolved trauma or a deeply distressing event. By targeting the emotional root of the trauma, EMDR can help clients reduce triggers, minimize anxiety, and restore a sense of safety and calm in their lives.

Harm Reduction Model

Recovery from an eating disorder is often a gradual process, and the harm reduction model recognizes this reality. Instead of pushing for immediate, complete recovery—which can feel overwhelming or unrealistic for some individuals—the harm reduction approach emphasizes making small, incremental changes that reduce the negative impact of the eating disorder. This method is compassionate, non-judgmental, and focused on progress rather than perfection.

Harm reduction therapy is ideal for those who may not be ready to fully commit to traditional treatment approaches but want to start making positive changes. By focusing on manageable, realistic goals, clients can experience success in reducing harmful behaviors, improving their relationship with food, and fostering a healthier mindset. Over time, these small steps accumulate and create the momentum needed to achieve long-term recovery.

A Holistic Approach to Healing

Every person’s journey with an eating disorder is unique, and no single therapy fits all. By using a combination of trauma-informed therapy, narrative therapy, somatic therapy, EMDR, and the harm reduction model, I offer a personalized treatment plan designed to support clients at every stage of their healing process. The goal is to help you reconnect with your body, redefine your identity, and rebuild a healthy relationship with food. Whether you’re just beginning your recovery journey or looking to deepen your healing, these therapeutic approaches can support you in creating lasting change.

If you’re ready to explore how these therapies can help you on your path to healing, I invite you to reach out. Together, we can build a treatment plan that meets your unique needs and helps you take the next step toward a more balanced, fulfilling life.

While there are many effective therapies for eating disorders, the best therapy depends on your specific situation and needs. A combination of therapies is often used to address the multifaceted nature of eating disorders.

Yes, therapy can definitely help with eating habits, especially when it comes to eating disorders. While therapy doesn’t directly focus on the physical mechanics of eating, it plays a crucial role in addressing the psychological and emotional factors that influence eating behaviors. For many people struggling with an eating disorder, the underlying issues aren’t just about food; they’re deeply tied to emotions, thoughts, and beliefs about the body, self-worth, and control. Therapy helps identify and work through these emotional triggers, which can help shift unhelpful patterns and promote healthier attitudes toward food.

In some cases, though, therapy alone might not be enough, and it’s common to need more support. That’s where building a holistic care team can be incredibly helpful. By working collaboratively with a mental health counselor, a dietitian, and primary care providers, you can address all aspects of the eating disorder. 

Together, these professionals can create a comprehensive treatment plan that supports your needs. This collaborative approach helps ensure that you’re receiving the full spectrum of care needed for recovery, allowing you to heal more and regain a better relationship with both food and your body. 

Helpful ways to support someone with an eating disorder include being a compassionate, non-judgmental presence. Offer support without pushing too hard, and encourage them to seek professional help from a therapist, dietitian, or doctor who specializes in eating disorders. Let them know you’re there for them, but respect their pace and their journey. 

Supporting someone with an eating disorder requires compassion, patience, and setting healthy boundaries. Start by expressing concern for their emotional well-being rather than focusing on food or weight, and let them know you care. Be patient and avoid pressuring them into treatment. Let them know you’re there when they’re ready. 

Gently encourage professional help without pushing, offering resources and support when the time feels right. At the same time, take care of your own emotional health and set boundaries to avoid feeling drained. 

Finally, if the situation becomes serious, such as extreme weight loss or health concerns, be prepared to involve others, like family or professionals, to ensure their safety. Supporting someone through an eating disorder can be challenging, but approaching it with care and setting limits will help both of you.

The recovery cycle of eating disorders is a complex and often non-linear process. It involves multiple stages, each with its own set of challenges and growth opportunities. Recovery doesn’t happen overnight, and it’s important to recognize that setbacks are a normal part of the journey. Here’s an in-depth look at each stage of the recovery cycle:

1. Pre-contemplation

In this initial stage, a person may not recognize that they have an eating disorder or may be in denial about the impact it’s having on their life. They might feel like their behaviors with food, body image, or exercise are just part of their routine or even necessary to feel “in control.” Denial often protects individuals from the painful truths about their behaviors, but it can also prevent them from seeking help. In some cases, individuals might not even be aware that they have a problem until it starts affecting their relationships, work, or overall well-being.

2. Contemplation

During the contemplation phase, a person begins to recognize that something is wrong. They may start to notice the negative impact their eating behaviors have on their physical and emotional health, but they may still feel conflicted or unsure about making changes. This stage is often marked by ambivalence—while the person sees the need for change, they may be afraid of what recovery will entail or uncertain about their ability to make lasting changes. The contemplation phase can be difficult because it involves a lot of internal conflict, and the person may struggle with whether they are ready to face the challenges of recovery.

3. Preparation

In this stage, the person begins to take concrete steps toward recovery. They recognize the need for help and start to prepare for the changes they want to make. This might include researching treatment options, talking to a therapist, reaching out to a dietitian, or finding support groups. Preparation can involve setting realistic goals and creating a plan of action, such as scheduling appointments with professionals or committing to self-care practices. This stage is often a turning point, as the person transitions from thinking about recovery to actively seeking solutions and taking responsibility for their healing journey.

4. Action

The action phase is where recovery truly begins. This is when the person actively works on addressing the underlying emotional, psychological, and behavioral issues contributing to the eating disorder. They may begin attending therapy, implementing new coping strategies, and taking steps to change harmful eating behaviors. This is also the phase where individuals start to explore deeper emotional issues, such as past trauma, low self-esteem, or perfectionism, that may be fueling their disordered relationship with food. Change during this stage can be difficult and requires a lot of emotional and physical energy. However, this is where real progress happens, as individuals commit to their recovery, sometimes with the help of a mental health professional, dietitian, or support group.

5. Maintenance

Once the person has made significant progress, the maintenance phase focuses on sustaining the gains they’ve made and preventing relapse. In this stage, they work on integrating healthy habits and coping mechanisms into their daily life to support long-term recovery. This might involve using tools learned in therapy, practicing self-compassion, and reinforcing healthy eating patterns. During maintenance, individuals focus on continuing to challenge old patterns of thinking and behavior while embracing a more positive and realistic relationship with food and their bodies. Regular check-ins with a therapist or support group can be helpful in this phase to ensure the person stays on track and continues to work toward their recovery goals.

6. Relapse

Setbacks and relapses are an unfortunate part of many recovery journeys. Relapse doesn’t mean failure—it’s a signal that the person may need additional support or adjustments in their treatment. Many people in recovery experience a relapse at some point, whether it’s a return to old eating habits, a dip in self-esteem, or a resurgence of disordered thoughts. The key is not to see relapse as a defeat but as an opportunity to re-engage with the recovery process. Relapse can be a valuable learning experience, helping the individual understand what led to the setback and what steps need to be taken to get back on track. When a relapse happens, it’s important to reconnect with a therapist or treatment team, review the coping skills that have worked in the past, and recommit to the healing process.

Here’s a broad overview of the four levels of eating disorder treatment, ranging from the least to most intensive care:

1. Outpatient Treatment

This is the least intensive level of care, where individuals attend therapy and counseling sessions but continue living at home. It’s best for people with mild to moderate eating disorders who can still manage their daily lives. 

2. Intensive Outpatient Program (IOP)

IOP offers more support than outpatient treatment. People in IOP attend therapy multiple days a week (3-5 days) but still live at home. It’s suitable for those with more severe eating disorders who need extra help but don’t need 24-hour care. 

3. Partial Hospitalization Program (PHP)

PHP is more intensive than IOP, with treatment lasting most of the day (usually 5-7 days a week). It’s for people who need more support than IOP but don’t need to stay overnight in a hospital. 

4. Inpatient/Residential Treatment

This is the most intensive level of care, where individuals live full-time in a treatment facility, receiving 24/7 medical and psychological support. It’s for people with severe eating disorders who need round-the-clock care. 

A variety of professionals can support people with eating disorders, and often, a collaborative approach involving more than one specialist is most effective.

Some of the key professionals who work with eating disorders include:

Therapists: Therapists help with the emotional and mental side of eating disorders. Through talking and different types of therapy, they help you understand why you feel the way you do about food and your body and support you in feeling differently about yourself.

Doctors: Doctors are there to check your overall health and make sure your body is okay. They do medical exams and help keep track of your physical health as you work through recovery.

Dietitians: Dietitians help you learn how to eat in a healthy way without focusing on weight loss or dieting. They guide you in making balanced food choices that nourish your body and support your recovery.

Eating disorders can look many different ways for each person; sometimes, we might see these characteristics in ourselves or in others, and sometimes, they might look different. Eating disorders come in all shapes and sizes. But here are four characteristics that can show up. 

Preoccupation with Food and Body Image: A person with disordered eating often spends a lot of time thinking about food, eating, and their body. They might constantly worry about their weight, shape, or what they eat, which can interfere with daily life and relationships.

Unhealthy Eating Patterns: Disordered eating can involve extreme behaviors like overeating, undereating, or strict dieting. This may include skipping meals, binge eating, or following very restrictive eating rules, such as only eating certain “safe” foods or counting every calorie.

Distorted Body Image: A person with disordered eating often has a distorted view of their body. They might feel like they are “too big” or “not good enough” despite others telling them they look fine. This distorted self-image can lead to extreme behaviors aimed at changing their body.

Obsession with Food Rules or “Good” vs. “Bad” Foods: People with disordered eating may create rigid rules about what foods are “acceptable” or “unacceptable.” They might avoid entire food groups, like carbs or fats, or feel guilt when eating certain foods. This can lead to a cycle of restriction and overeating.