Working with Eating Disorders

Written by Cassie Kerns, Med, LPC Intern

We talk about relationships between people all the time. We constantly see headlines on social media titled “7 Ways to Communicate Better” or “How to Know if They’re Into You.” But what about our relationship with food? Have you ever thought about it? With today’s obsession with healthy eating and restrictions such as “gluten free” or “non-dairy”, fad diets, and the increasing posting of calories in certain foods, it’s difficult to avoid thinking about what we are putting into our bodies. But when does “thinking about” become “obsessing about?” Have you ever wondered if you or someone close to you has a problem?

Many people who develop eating disorders believe that everybody else loves their bodies. The truth is, you’re not always going to love your body. In fact, I’ve never met a single person who could honestly tell me they love everything about their body.

What is an Eating Disorder?

The most common eating disorders are anorexia, bulimia, and binge eating. Eating disorders involve an obsession with weight loss, phobia of weight gain, and/or obsession with thoughts of food. These thoughts lead to behaviors like calorie restriction, overeating, excessive exercise, vomiting, and taking diet pills or laxatives. Eating disorders are serious mental illnesses and potentially life threatening, and they are very complex. Many people want to see the illness as a “disorder of choice,” as if the person made the “choice” to have an eating disorder and should make the “choice” to stop having one. It’s important to understand that well meaning advice may be going to a brain that has been hijacked by a mental illness.

Because eating disorders often co-occur with depression, anxiety, substance use, obsessive compulsive disorders, or personality disorders, recovery can be incredibly difficult for the individual and his or her loved ones. Depression, anxiety, and emotional dysregulation not only occur commonly alongside an eating disorder, but also persist after eating disorder recovery (Eating Recovery Center).

Here are some questions to help you determine if eating disorders are affecting your life. Does food seem to dominate your life? Do you feel like you have lost control over how much you eat? Do you believe you are fat when others say you are too thin? Do you make yourself sick because you are uncomfortably full or because you feel guilty about what you ate? If the answer to one or more of these questions is “yes,” you may be struggling with an eating disorder, and you don’t have to do this alone.


Therapy goals include recognizing hunger and fullness cues, eating a variety of foods without fear, developing body awareness, normalizing eating habits (meals, celebrations, snacks, and restaurants), recognizing connections between food intake and emotions, developing a variety of coping skills to manage urges, and distress tolerance. Coordination of care with a registered dietitian to help with meal planning is also essential in order to reach and maintain a healthy BMI. Therapy should also address the co-occurring illnesses mentioned above.

Let’s explore the “why” behind some of these goals and the process of reaching them. People without an eating disorder generally recognize when they receive cues from their bodies signaling fullness or hunger. Those with an eating disorder, however, may not. For example, a person who regularly restricts what they eat gets used to the feeling of hunger, and becomes numb to it. The same idea applies for someone who is accustomed to overeating, in which they no longer recognize the “I’m full” cue in their body. So, learning to recognize these cues is essential in the healing process.

Have you ever heard the expression “replace a habit with a hobby?” It’s a great idea, because taking something away without replacing it with something else is just not possible. Whatever was taken away will be replaced by something, whether it’s intended or not. So, learning and developing a variety of coping skills can help to replace the bad habit with something good. Because of how addictive and consuming eating disorders are, people who are able to replace that habit with a hobby discover amazing talents and skills. How cool is that?!

Distress tolerance is another important skill to build. Eating disorders are a type of addiction, much like substance abuse is an addiction, and recovery from an addiction requires the ability to tolerate significant distress. Building distress tolerance in therapy happens with exposure to slightly distressing situations in small doses, followed by transitioning back to a safe place. Practicing this transition in therapy over a period of time is a key element of recovery.

These are just a few simply stated interventions used in therapy. With support and treatment, recovery IS attainable and so worth it!

For more information visit Eating Recover Center or visit the client portal to book an appointment with Cassie.

This article was written by Cassie Kerns, Med, LPC Intern. Cassie has a passion for working with those struggling to find a healthy relationship with their bodies. 

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