Eating Disorders Therapy Options: Which Treatment Is Right For You?

Millions of people worldwide experience eating disorders, which are typically characterized by harmful eating habits, such as binge eating or restricting food intake. These habits can quickly spiral and affect not only physical health but also mental well-being. For those seeking treatment, therapy can be a key part of overcoming eating disorders.

Several types of therapy can help. Cognitive behavioral therapy is often the first choice and typically focuses on changing harmful thoughts and behaviors related to eating and body image. Other useful options may include dialectical behavior therapy and art therapy. For those seeking flexibility, online therapy may also be beneficial.

What are the different types of eating disorders?

Eating disorders come in various forms, each with its own symptoms and challenges. Awareness of these differences can support efforts to identify and confront negative eating habits.

Anorexia nervosa

Anorexia nervosa is a serious eating disorder in which people typically restrict their food intake because they have a strong fear of gaining weight. Even when they are underweight, they often believe they are overweight. Common signs of anorexia can include severe weight loss, an obsession with dieting, and excessive exercise.

Bulimia nervosa

Bulimia nervosa generally involves episodes of binge eating followed by purging to prevent weight gain. This cycle can include vomiting, excessive use of laxatives, or extreme exercise. Symptoms may include consuming large amounts of food in one sitting, hiding eating habits, and developing tooth decay from frequent vomiting.

Binge eating disorder

Binge eating disorder (BED) can be characterized by recurring episodes of eating large quantities of food, often quickly and to the point of discomfort. Unlike bulimia, BED does not involve purging. Key features generally include eating when not hungry, a sense of shame or guilt after binging, and eating in secret.

Avoidant/restrictive food intake disorder (ARFID)

ARFID usually involves limiting food intake, but unlike anorexia, it’s not due to body image concerns. People with ARFID might avoid food due to taste, texture, or a past choking incident. Signs may include a restricted range of foods eaten, avoidance of meals with others, and weight loss or nutritional deficiencies.

Other specified feeding or eating disorder (OSFED)

OSFED can be seen as a catch-all category for eating disorders that don't fully match other disorders' criteria. Examples include the following:

• Atypical anorexia (the individual’s weight is within or above the normal range)
• Bulimia nervosa with less frequent episodes
• Night eating syndrome (excessive eating at night)
• Purging disorder (purging without binge eating)

The impact of eating disorders on health and relationships with food

Eating disorders can make social situations involving meals seem stressful or isolating. Individuals may struggle to eat in front of others or avoid social gatherings altogether. Managing these disorders usually requires resolving deeper mental and emotional challenges.

Therapy options for treating eating disorders

There are many effective forms of therapy for eating disorders. Different approaches tend to target various aspects of the disorders, such as behaviors, emotions, and thought patterns.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy normally works by identifying and changing negative thought patterns and behaviors. Enhanced cognitive behavioral therapy is a type of CBT that can be particularly helpful for bulimia nervosa and binge eating disorder. It generally involves setting realistic goals, learning to cope with stress, and developing balanced eating habits. CBT may also help individuals manage the stress surrounding food and body image while teaching them how to more effectively monitor their eating patterns. 

Dialectical behavior therapy (DBT)

Dialectical behavior therapy can also be useful for treating eating disorders. DBT normally combines cognitive behavioral techniques with mindfulness practices. It can help people regulate their emotions and develop positive relationships with food. Skills training in DBT generally includes mindfulness, distress tolerance, and emotional regulation.

Interpersonal therapy (IPT)

Interpersonal therapy, which typically focuses on relationships and a person’s social life, may be a helpful way to treat eating disorders. This type of therapy often looks at how our connections with others can affect our eating habits. It frequently aims to solve problems like changes in roles (such as starting college), coping with loss, and working through conflicts with friends or family. By improving these relationships and building better support systems, IPT may reduce the urges to engage in harmful eating behaviors.

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy can help people learn to accept their thoughts and feelings instead of fighting against them. It usually encourages individuals to focus on what matters to them and take actions that reflect those values, even when they have difficult thoughts or emotions. For example, if someone struggles with unhealthy eating habits, ACT can help them recognize and accept their feelings about food without letting those feelings control their actions.

Psychodynamic therapy

Psychodynamic therapy usually looks at the deep feelings and thoughts that affect people's actions, especially when it comes to eating disorders. This type of therapy can help individuals understand the hidden reasons behind their behaviors, such as past experiences or emotional struggles. A licensed mental health professional can guide individuals to explore these feelings in therapy sessions. As a result, people may better understand why they behave the way they do and learn better ways to cope with their emotions.

Art therapy

Art therapy can be a creative way for people to express their feelings and thoughts. Instead of just talking about their emotions, individuals can use different art materials, like paint, clay, or drawing tools, to explore what they’re feeling. This can be helpful for those who find it hard to put their emotions into words.

Exposure therapy

Exposure therapy may be a helpful approach for people with certain eating disorders, like anorexia nervosa, who often fear certain foods or eating situations. In general, this type of therapy involves gradually introducing individuals to these feared foods in a safe and controlled way, allowing them to develop improved responses to their anxiety. This therapy can be part of both outpatient and residential treatment programs, making it a helpful resource for recovery.

Not every therapy option works the same for everyone. People may need to try different therapies to find what works best for them.

Other treatments for people with eating disorders 

Eating disorders are often complex, and there is no single treatment to cure them. Beyond therapy, eating disorder treatment may require a combination of approaches to help individuals recover.

In some cases, an individual’s doctor or psychiatrist may prescribe medications for co-occurring conditions or symptoms. These medications may improve emotional stability and reduce harmful eating behaviors. Always speak to your doctor before starting, stopping, or changing the way you take medication.

Nutritional counseling typically involves support from registered dietitians who create meal plans to encourage balanced eating habits. This guidance can help individuals build a positive relationship with food by focusing on meal planning and learning portion sizes to prevent relapse.

Medical monitoring normally includes regular check-ups with healthcare providers to manage health risks and prevent complications like heart issues and bone density loss. Lab tests and diagnostics can track physical health, which can help people get prompt treatment. 

The role of self-care for eating disorders

Self-care can also play a role in managing and recovering from eating disorders. Individuals can try different self-care practices to reconnect with their bodies and emotions in a positive way.

• Daily meditation and reflection: Taking five minutes each morning to reflect on a daily meditation reading or a motivational quote can provide a calm start to the day.
• Participating in enjoyable activities: Participating in hobbies and activities that bring joy can be a great form of self-care. Whether it's painting, hiking, or playing an instrument, doing something enjoyable may improve mental well-being.
• Practicing mindfulness: Mindfulness exercises, such as deep breathing or gentle yoga, may reduce anxiety and increase body awareness. This can be particularly helpful for those recovering from eating disorders.
• Maintaining a support system: Family and friends can provide emotional support. Sharing emotions and experiences with trusted individuals may reduce the sense of isolation often linked to eating disorders.

Find support for binge eating disorder, anorexia, and other eating disorders

Different support options are available for those experiencing eating disorders. For example, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) offers various free peer support services, as well as a treatment directory, support groups, and a mentorship program.

The National Eating Disorders Association (NEDA) also offers helpline services to support those with eating disorder concerns. They collaborate with several organizations to provide different levels of support.

Accessing these resources can help you or your loved ones find the necessary support and guidance as you overcome an eating disorder.

Online therapy options for eating disorders

Online therapy options may offer flexibility and accessibility, allowing individuals to receive professional treatment for eating disorders from the comfort of their homes. These services can allow people to integrate therapy seamlessly into their daily lives and may be as effective as in-person treatments for many people. 

Is online therapy effective for mental health conditions?

Online therapy can be effective for various mental health conditions, including eating disorders. A 2021 study examined the long-term effects of an online therapy program for people with eating disorders, comparing those who received the therapy to those who had to wait for it. After a year, around 70% of the participants who completed the therapy reported fewer eating disorder symptoms and improved body satisfaction. The therapy also improved participants’ overall health, mental well-being, and self-esteem.