Types Of Eating Disorders Counseling
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-4357
Eating disorders are complex mental health conditions that are typically characterized by persistent and severe disturbances in eating behaviors. They are often accompanied by distressing thoughts and emotions and can be serious conditions affecting multiple aspects of a person’s life.
Early intervention and treatment can be crucial to recovery, and multiple treatment approaches may be beneficial. Below are various types of eating disorders counseling that may be a part of a comprehensive treatment plan.
Inpatient or outpatient medical care
Eating disorders can be treated in a variety of settings. Many cases can be managed in an outpatient setting, which means the person lives at home and visits their doctors and counselors as needed. Some people may need to visit a treatment center multiple times a week for several hours at a time, while others may be able to go about their regular activities and check in with their team a few times a week. Outpatient programs may be an effective option for people who are medically stable and have the support they need to manage their own care.
Eating disorders can have significant effects on someone’s physical or mental health, and sometimes these problems must be addressed urgently. Hospitalization may be necessary to correct problems like electrolyte imbalances, abnormal heart rhythms, or low body temperatures or if someone is experiencing suicidal thoughts or experiencing a co-occurring drug or alcohol addiction.
Nutrition counseling
Nutrition counseling is often a crucial part of recovering from an eating disorder. Specially trained dieticians, often with a specialized certification from the International Association of Eating Disorder Professionals, often help people in recovery learn about food and their bodies. During this counseling, a registered dietitian typically offers emotional support while educating individuals about nutrition, eating disorders, meal planning, and nutritional needs. This education can also include teaching about metabolism, hunger cues, and how to better understand the human body’s needs.
Cognitive-behavioral therapy (CBT)
Psychotherapy is often an important part of recovery for people with eating disorders. One therapy approach that may be effective is CBT or, more specifically, enhanced cognitive behavioral therapy (CBT-E). CBT-E may help people with eating disorders learn how to address the thoughts and behaviors contributing to their eating disorder, overcome a distorted body image, and re-establish a regular eating pattern.
This form of psychotherapy can be extensive, lasting anywhere from six months to a year. Sessions may occur multiple times a week in the beginning, then weekly, then every other week. Every case is different, but CBT-E sessions for eating disorders may involve weekly weigh-ins, structured eating plans, and keeping food diaries.
CBT-E often has four stages:
Stage 1
Stage 1 typically focuses on understanding the specific challenges a person faces in regard to food and eating. This stage may help the therapist determine the specific problems the person faces and how best to help them meet their treatment goals. In this stage, the person typically works to establish healthy eating patterns, so they may keep a diary of everything they eat as well as their thoughts and feelings.
Stage 2
This stage tends to be transitional, focusing on reviewing the progress made in stage 1 and planning for the rest of recovery, including anything that the person in treatment wants to learn. The therapist may help the person identify any barriers that may impede progress and decide what to focus on in the next stage of treatment.
Stage 3
In stage 3, treatment typically focuses on things that may be continuing to contribute to unhealthy eating behaviors and attitudes toward food. These factors can be unique to everyone, but they can include handling day-to-day stress, working through negative thoughts about appearance, and addressing challenges with low self-esteem and other interpersonal problems that may act as barriers to recovery. Individuals in therapy may learn to prioritize areas of life other than food and dieting,
Stage 4
By this stage, the person generally only has sessions every other week that focus on the future and how to continue to apply the skills they have learned so they can continue to make progress. In stage 4, the person typically works with their therapist to learn how to deal with setbacks, phase out daily food logs and weights, and address any concerns they have about treatment coming to an end.
Interpersonal therapy (IPT)
Research has found that interpersonal therapy can also be effective at treating some eating disorders, specifically bulimia nervosa and binge eating disorder. This type of therapy typically centers on the idea that interpersonal difficulties affect some features of eating disorders, that problematic relationships directly relate to a person’s current mood, and that improving mood can lead to improved relationships.
Relationship problems can be common in people with eating disorders, which can lead to isolation from the support and normalizing behaviors of friends, family, and peers, which allows eating disorder symptoms to “persist unchallenged.” Addressing these relationship concerns may help someone recover from eating disorder symptoms.
Dialectical behavioral therapy (DBT)
DBT was developed as a way to treat borderline personality disorder (BPD) but has been adapted to treating disorders as researchers believe that eating disorder symptoms may serve as a way to regulate emotions. DBT typically treats these symptoms by focusing on learning emotional regulation and a balanced approach to eating.
In DBT, people with eating disorders often learn mindfulness and emotional regulation through both individual and group sessions. They typically learn to apply these skills to a variety of behaviors, such as substance use, binge eating, purging, and food restriction. People in this treatment can have coaching calls with their therapist between sessions if needed, and they often have homework to complete, such as keeping a diary to monitor symptoms and track progress.
Family-based therapy (FBT)
Family-based therapy can be an effective treatment for some eating disorders in children and adolescents, particularly anorexia nervosa. In fact, some consider FBT to be the treatment of choice for adolescents with anorexia who are able to participate in outpatient treatment.
For anorexia, FBT typically has three phases. The first is typically to restore the person’s physical health, the process of which is managed by the patient’s parents. FBT allows young people with anorexia to recover in their homes with the support of their families instead of having to go to a residential treatment program. A person with anorexia typically has a difficult time making decisions about food and eating, so these decisions are initially given to the parents to control. Parents usually decide what and how much their children eat and when they eat, and they monitor food intake while limiting or eliminating physical activity.
When the adolescent is experiencing a steady increase in body weight and eating without resistance, the focus typically shifts to slowly giving responsibility for their food and eating choices back to them. This shift usually happens gradually to prevent backsliding, and parents still have some oversight. For example, adolescents may serve themselves portions of the meals the parents prepared, but parents can still add food to their plates if they feel it is not enough.
Once this transition is complete and the adolescent is responsible for their own food choices, the therapist works with the family to ensure everything is back on track. The therapist typically also helps the family plan for future challenges the adolescent may face to prevent them from reverting to previous disordered eating behaviors.
Effectiveness of treatment for eating disorders
Eating disorders can be challenging to treat. The success of various types of therapy can depend on the type of eating disorder and its severity. Recovery and remission rates vary; one review found that 42% of participants had full remission.
Anorexia nervosa
Research has found that while 75% of people with anorexia make a partial recovery, only 21% recover completely. This study found that, of these, 94% maintained their recovery two years later, but those who made only a partial recovery were more susceptible to relapse.
Bulimia nervosa
Studies have found that between 40% and 60% of people with bulimia recover, but less than 40% achieve full recovery and about 30% relapse.
Binge eating disorder
Research shows that both CBT and IPT are effective at treating binge eating disorder, with one study finding that 64.4% of patients experienced a full recovery after treatment and 80% were in long-term remission.
Online therapy for binge eating disorder and other disorders
For those who may feel hesitant to participate in traditional in-person therapy, online therapy can be a flexible and convenient option. With an online therapy platform, you can work with a licensed mental health professional from the comfort of your home or anywhere you have a reliable internet connection. Sessions can take place via audio, video, live chat, or a combination of these methods. Most people are matched with a therapist within 48 hours, so you can get started with treatment right away.
How effective is online therapy for eating disorders?
Research has found that online therapy can be an effective treatment for eating disorders (ED). One study found that “short-term clinical outcomes with virtual and in-person ED therapies are comparable.” The study highlighted the potential for online treatment to overcome barriers to specialized treatments, such as geographical distance.
Takeaway
If you’re experiencing symptoms of an eating disorder, know that you’re not alone. With BetterHelp, you can be matched with a licensed therapist who has experience treating eating disorders. Take the first step toward getting support with an eating disorder and contact BetterHelp today.
How to deal with eating disorders?
An eating disorder typically will not resolve without professional treatment, so seeking the support of a primary care provider or mental health care provider as soon as possible is typically recommended for those experiencing symptoms. Eating disorders are treated in different ways depending on the disorder, its severity, and any co-occurring mental health condition or conditions the person may be living with, but talk therapy is usually a key component, sometimes in combination with medical stabilization, medication, and/or nutrition education.
Enhanced cognitive behavioral therapy and dialectical behavior therapy are commonly used forms of talk therapy designed to help a person shift negative thinking patterns and improve a distorted self-image. They may be part of an inpatient program or outpatient therapy. In addition to these types of individual therapy, family-based treatment could be recommended to support family members and the family unit as a whole in some cases.
How to counsel an eating disorder patient?
According to an article published by Wake Forest University's counseling program, counselors who see clients with eating disorders often use a few key approaches for treatment. Examples include identifying environmental factors that may be contributing to symptoms, setting manageable goals that may aid in symptom reduction, and guiding the client through enhanced cognitive behavioral therapy, which research suggests can be particularly effective for eating disorders.
Note that a therapist or counselor is usually only one part of the treatment team for a person with an eating disorder. Medical care and nutrition support may also be required in some cases—such as when symptoms are life-threatening.
What are some coping strategies for eating disorders?
Eating disorder recovery typically requires that the individual seek treatment from a licensed mental health care professional and, in some cases, a medical professional as well. In addition, some self-care strategies and coping mechanisms may be helpful to implement to promote eating disorder recovery and overall physical and mental health. Some examples include limiting time spent on social media or unfollowing accounts that negatively affect self-esteem or body image, building a strong support system that you can lean on when feeling the urge to engage in eating disorder behaviors, engaging in hobbies you enjoy that are unrelated to food or appearance, and practicing mindfulness meditation regularly.
How to help a loved one with an eating disorder?
The National Eating Disorders Association (NEDA) recommends being gentle but firm with a loved one showing signs of an eating disorder. You might gently but strongly encourage them to seek treatment (unless it's a medical emergency, in which case you should generally seek immediate emergency care on their behalf). It may also help to avoid judgmental or shaming language, instead aiming to be compassionate and supportive. Learning everything you can about eating disorders can be helpful as well, as can seeing a therapist yourself or engaging in family therapy for emotional support as your loved one works toward healing.
How do I help myself with binge eating disorder?
Binge eating disorder, like other diagnosable eating disorders, is a mental illness. If you don't seek treatment for any mental illness, symptoms are unlikely to resolve on their own. To do so, you could see a doctor for a physical examination and to address any medical complications, such as acid reflux or other digestive issues. Then, they may help you find treatment from a mental health care provider(s), who can help address underlying causes and any co-occurring conditions like depression, obsessive-compulsive disorder, or anxiety. This care could take the form of enrollment in a residential treatment facility, intensive outpatient therapy, or some other form of therapeutic support.
How do you respond to someone who has an eating disorder?
When engaging with someone who has an eating disorder, it's generally best to avoid commenting on their appearance or eating habits. You might also aim to be compassionate and empathetic rather than judgmental. If you have a close relationship, gently encouraging them to seek help if they haven't already and directing them to helpful online resources—such as the National Alliance on Mental Illness’ resource page—could also be important.
How to support a client with an eating disorder?
A client with an eating disorder will typically need ongoing mental health support in order to achieve recovery. A qualified mental health care provider will typically help them recognize factors that may be contributing to their symptoms, shift distorted thinking patterns about food and their body image, and listen to their feelings without judgment. If you are not a mental healthcare provider who is qualified to support an individual with an eating disorder, referring them to a qualified provider or otherwise helping them find the appropriate care is generally recommended. If you are an eating disorder specialist, you may find additional information and resources on supporting clients from the International Association of Eating Disorders Professionals.
How do you talk to someone about an eating disorder?
If you've noticed signs of an eating disorder in a loved one—such as binge episodes, forced vomiting, excessive exercise, eating too narrow a range of certain foods, or other restrictive eating—it's generally recommended that you gently encourage them or help them seek treatment. Without professional care, some eating disorders may lead to long-term complications, brain damage, and even death, so support for help-seeking behaviors can be critical.
Why should we care about eating disorders?
Eating disorders (EDs) affect millions of people each year—meaning you likely know someone who has or had an ED. These illnesses can significantly disrupt the individual’s daily life, work, relationships, and well-being, sometimes causing long-term harm. Eating disorders are estimated to cost the United States $64.7 billion each year and cause approximately 10,200 deaths each year, making them a significant public health issue.
How can we prevent eating disorders?
Researchers are unsure as to the exact cause of eating disorders, but they suspect that environmental factors likely play a role. As a result, promoting media portrayal of diverse body sizes and shapes, teaching young people social media literacy skills and helping build their self-esteem, and helping reduce stigma around seeking mental health care are all examples of ways that the broader population may help prevent eating disorders.
- Previous Article
- Next Article