feature image by Gerd Altmann from Pixabay
how I see it
In my practice, I do not officially assess or diagnose eating disorders. People come to me because their relationship with food isn’t right, and they could use some professional help.
Struggles with food, weight, body image, and emotional eating can be overwhelming, but you don’t have to work through them alone. I offer compassionate support for:
- Eating disorders – Binge eating, compulsive overeating, bulimia, purging disorder, and orthorexia
- Food addiction – a physical or emotional attachment to certain foods and/or ingredients
- Emotional eating – from stress and/or habit, and stress eating, grazing, and other complex behaviors
- Body image – concerns about appearance, weight, and self-esteem issues
- Obsessive thinking – often accompanies any of the above
Note, I do not work with anorexia, since special medical care is beyond my scope. But a number of my clients have anorexia in their past.
Binge-eating is very much a part of my own past. Since the age of 10-11, binge-eating and the resultant obesity took over my life. I was unable to stop these self-destructive behaviors which continued throughout my teens into young adulthood. I didn’t find help until my mid-30s, and I have been in recovery mode ever since.
All forms of disordered eating are complex and can go way beyond a person’s relationship with food. Shame, obsessive thinking, negative self-worth, and an overwhelming sense of failure can wreak havoc on lives not fully lived. And on unknown needs not fully met.
The aim of therapy is first to help you uncover what your disordered eating is hiding.
What lies beneath? Thoughts, feelings, fears, wants, unmet needs, beliefs and attitudes?
And then to help you explore the way out — and through — until it no longer preoccupies your life.
You give up the food / behavior, you gain a piece of your true self
You become free
Below are some disordered eating tools you may find helpful, including questions, symptoms, recovery keys and definitions. You can find these and more on the tools page.
25 questions: do I have disordered eating?
Physical: How often does your body suffer because …
- You can’t say no to a food craving – you have to have it
- Once you start binge-eating, you can’t stop
- You’ve eaten way past the point of fullness, to the point of discomfort
- You wake up feeling hung-over, bloated, sluggish, and sometimes nauseous
- Your clothes are too tight (but you don’t want to buy new ones until you lose weight)
- Your weight fluctuates up and down like a yo-yo
- You feel tired a lot of the time because you are eating so much junk
- You feel like you’re stuck in a cycle
Mental: How much time do you think about or obsess over …
- Food you’ve already eaten, should eat, shouldn’t eat, plan to eat, want to eat, wish you hadn’t eaten
- How much weight you’ve gained, lost, regained or want to lose
- How much exercise you used to do, don’t want to do, should be doing, are doing now, wish you were doing
- How different your life would be if you were a certain size or weight
- Whether or not there is any diet or weight loss scheme you haven’t tried
Emotional: How much time do you spend hating how you feel because …
- You can’t seem to control your eating, at least not for very long, and certainly not as long as you used to
- You can’t let anyone see what or how much you eat
- You’re tired of feeling frustrated, disappointed, ashamed, guilty and hopeless
- You wake up feeling bad because of what you’ve eaten the night before
- You go to sleep feeling bad because of what you’ve eaten that day
- You let the scale decide whether your day will be a good or bad day
- You feel stuck — you’ve been here too many times before
Social: How often do you avoid social situations because …
- You can’t commit to anything in case you have a binge or purge session, or both
- You avoid getting together with friends whenever food is involved, so they won’t comment on how much or how little you are eating
- You avoid parties because of the food that’s usually there — you won’t be able to stop thinking about it, and worry that others might see you eat
- You don’t feel good about the way you look
- You can’t go to the gym because you’re embarrassed about how you look in gym clothes
Top 20 symptoms of emotional eating
Most people do some emotional eating, under stress or when celebrating.
But occasional emotional eating can become a hard-to-break habit, lead to binge-eating, bulimia or food addiction, and difficult to change.
How many of these top 20 emotional eating symptoms apply to you?
1. You eat for comfort
2. You eat when you’re bored
3. You eat when you’re stressed out
4. You use food as reward
5. You eat to stop what you don’t want to feel
6. You use food to squelch anger, frustration, or fear
7. You eat to avoid any sadness or grief
8. You eat when confused, to get some relief
9. You use food when faced with a lack of hope
10. You eat as a way to help you cope
11. You eat to get calm if you make a mistake
12. You use food when you’ve got a decision to make
13. You eat even when you’re not hungry
14. You eat even when you feel full
15. You use food as a friend, when you feel alone
16. You love shopping for goodies to savor at home
17. You eat for the pleasure and for the food-fun
18. You use food to wind down when your day is done
19. You think about food and eating a lot
20. Food helps you pretend all is fine, when it’s not
7 keys to recovery from disordered eating
In therapy, your recovery from disordered eating will probably focus on a number of key elements, based on your unique history.
Recovery is an evolving process—and what works best will look different for each individual. A sustainable recovery is flexible, and elements may shift over time. The main thing is to stay open, curious, and patient with yourself as you explore what is right for you.
- Develop your self-awareness
Gain a deeper understanding around food, eating behaviors, and your relationship with food - Identify your triggers
Figure out what sets you off into the self-destructive eating behavior - Recognize your thoughts and feelings
What are your thought patterns and their accompanying emotions and consequences?
What are your feelings/emotions and their accompanying thoughts and consequences? - Build your self-worth
You’ll feel empowered to accept yourself and gain self-trust and emotional resilience. Self-worth is an inside job. - Explore your alternatives
You’ll find more constructive ways to manage stress, instead of disordered eating - Discover hidden qualities
As you let go of disordered eating, you’ll find strengths and abilities you didn’t know you had - Practice kindness
Embrace self-compassion and be kind to yourself, which includes saying goodbye to negative-self-talk
Disordered eating definitions
Here are some very brief definitions for the most common types of disordered eating.
Binge-Eating (BED)
The most prevalent — more than bulimia and anorexia combined
You consume a lot of food in a short time
You can’t stop bingeing, which is out-of-control, compulsive, impulsive
Bulimia (BN)
Binge-eating / overeating followed by purging
You can’t stop either behavior, which is out-of-control, compulsive, impulsive
You might purge by vomiting, using laxatives, over-exercising, or food restriction
Anorexia (AN)
The most deadly
You increasingly develop severe food restriction, which can lead to death
You need to feel in control; you become addicted to resisting food
Orthorexia
On the increase
You become preoccupied with eating “healthy”
You restrict food with excessive / obsessive worry
Emotional/stress eating
Instead of physical hunger, you eat in response to feelings, physical and emotional
You turn to food for comfort or stress relief
Your behavior can be linked to dieting or food restriction
Food addiction
Controversial. Compulsive overeating of highly palatable foods (rich in sugar, fat, salt)
Your brain’s reward system is activated, similar to substance addiction
You can lose control, develop frequent cravings, and suffer negative health effects
Note that food addiction is not (yet) recognized as an eating disorder, but it can be part of one. Research increasingly shows that people can become addicted to certain behaviors, and to certain foods like sugar, fat, salt or any combination of these — the ingredients in most junk and ultra-processed food.
I’ve contributed a chapter to a textbook on food addiction (Processed Food Addiction: Foundations, Assessment and Recovery, 2018) showing that my own history meets all eleven criteria for substance use disorder (i.e., addiction) in the DSM-5.