Therapy for Eating Disorders, Disordered Eating, & Body Image
Therapy for eating disorders is about more than food.
Together, we work on understanding the
emotional, behavioral, and nervous system patterns that may be keeping you
stuck while building a healthier, more flexible relationship with food, movement, and your body.
What are eating disorders and disordered eating?
Eating disorders are mental health conditions involving distressing patterns around eating, food, movement, or body image. They can include anorexia nervosa, bulimia nervosa, binge-eating disorder, ARFID, and OSFED. They can affect people of any body size and may not be obvious to others.
Disordered eating describes patterns that cause distress or interfere with your health or daily life, whether or not they meet the criteria for a specific diagnosis. This might involve rigid food rules, restriction, bingeing, compensatory behaviors, or a preoccupation with “healthy” eating, weight, or exercise.
Food and body concerns can affect how you eat, move, think about yourself, and participate in daily life. You don’t need a specific diagnosis, a certain body size, or to feel “sick enough” to ask for support.
Signs to look out for
Eating and movement concerns may include:
- Skipping meals, restricting food, or cutting out foods or food groups
- Feeling unable to eat certain foods or handle changes to food routines
- Binge eating or feeling out of control around food
- Purging, fasting, or exercising to compensate for eating
- Compulsive movement or exercising despite illness, injury, or exhaustion
- Food rules that are becoming harder to follow or causing distress
You might also notice:
- Frequent thoughts about food, weight, shape, or exercise
- Anxiety, guilt, shame, or irritability related to eating or body changes
- Eating in secret, avoiding meals with others, or withdrawing from social activities
- Feeling that your worth, success, or sense of control depends on your body or eating
What can body-image struggles look like?
Body-image distress is more than having an occasional difficult day. It may take up a lot of your attention or start shaping what you do.
You might:
- Check, compare, measure, or seek reassurance about your body often
- Avoid mirrors, photographs, certain clothes, intimacy, or activities because of how you feel about your appearance
- Feel distressed by normal body changes
- Put off plans or experiences until your body looks or feels different
- Judge yourself harshly or tie your self-worth to weight, shape, or appearance
You don’t have to love your body to make progress. Therapy can help you spend less time caught up in body criticism and build a more neutral, respectful relationship with your body.
How I approach treatment
I look at both the patterns you want to change and what may be sustaining them. Together, we can explore how anxiety, perfectionism, control, shame, trauma, or compulsive patterns relate to food, movement, and body image.
I also offer individual meal-support therapy: a 45-minute session during a meal where we can practice responding to anxiety, urges, or rituals in real time.
Treatment is tailored to you. Progress might look like loosening a food rule, eating a feared food, reducing body checking or compulsive movement, or spending less of your day preoccupied with food and your body.
Depending on your needs, therapy may include:
Understanding how thoughts, emotions, and behaviors reinforce eating concerns and to practice more flexible responses.
Gradually facing feared foods, eating situations, body-image triggers, or uncertainty without relying on avoidance, rituals, or compensatory behaviors.
Understanding the parts of you connected to control, restriction, bingeing, or body criticism with curiosity rather than judgment.
Learning to manage intense emotions and urges, stay present with discomfort, and develop ways to respond that support your recovery.
EMDR when distressing past experiences are connected to current feelings about food, safety, control, or your body. We would consider together whether it fits your goals and when you feel ready for that work.
Body-image work to reduce checking, comparison, avoidance, and self-criticism while making more room for the parts of life you want to be present for.
Common questions about therapy
Do I need to have an eating disorder diagnosis to work with you?
No. You do not need a diagnosis, a certain body size, or to feel like your relationship with food is “bad enough” to deserve support. I work with eating disorders as well as disordered eating, chronic dieting, food anxiety, rigid food rules, body image concerns, and patterns that make eating feel stressful or complicated.
How do I know if my relationship with food is something I should bring to therapy?
If thoughts about food, your body, weight, exercise, or eating are taking up a significant amount of mental space, interfering with your life, or making you feel like you have to follow certain rules to feel okay, it may be worth exploring. You do not have to wait until things become more severe to ask for help.
What eating disorders and concerns do you work with?
I work with individuals experiencing restrictive eating disorders, binge eating, OSFED, orthorexia, disordered eating, compulsive or rigid exercise, food anxiety, body image concerns, and fear or avoidance surrounding certain foods. Treatment is individualized based on what you are experiencing rather than solely on a diagnosis.
What does eating disorder therapy with you actually look like?
It depends on what is keeping you stuck. We may work on challenging food rules, reducing checking and comparison, increasing flexibility, understanding patterns around restriction or bingeing, tolerating fullness or uncertainty, addressing perfectionism and control, and changing the behaviors that reinforce fear. I draw from CBT, ERP, DBT, and IFS depending on your needs.
Do you use ERP for eating disorders and food anxiety?
Yes, when it is clinically appropriate. ERP can be especially helpful when anxiety and avoidance are maintaining rigid patterns around food. This might include gradually practicing feared foods, tolerating uncertainty about ingredients or portions, reducing checking or compensatory behaviors, or becoming more comfortable with sensations such as fullness.
Can trauma affect my relationship with food or my body?
It can. Experiences from your past may influence how you relate to your body, safety, control, emotions, or eating in the present. When relevant, we can address both the current eating or body-image patterns and experiences that continue to carry emotional weight rather than treating them as completely separate concerns.
What if I don't want to give up all of my food or exercise rules?
That ambivalence is something we can talk about openly. You do not have to arrive at therapy completely ready to change everything. Part of treatment can involve understanding what those rules do for you, what feels scary about changing them, and what they may be costing you.
Will I need to work with a dietitian too?
Sometimes. Therapy and nutrition counseling serve different purposes in eating disorder treatment. Depending on your symptoms and needs, I may recommend working with an eating disorder-informed registered dietitian and/or medical provider alongside therapy. When appropriate and with your permission, I can collaborate with other members of your treatment team.
Do you work with people who exercise excessively or feel guilty when they rest?
Yes. Exercise can become connected to anxiety, compensation, body image, perfectionism, or a need to feel in control. We can work on the thoughts and fears surrounding movement while building a more flexible relationship with exercise and rest.
Do you provide meal support?
Yes. Meal support can provide an opportunity to practice skills in real time rather than only talking about food anxiety in session. Depending on your treatment needs, we may use meals or snacks to practice exposures, challenge avoidance or rituals, tolerate discomfort, and build greater flexibility around eating.