• Eating disorders are often deep-rooted problems that can be complicated to overcome

  • Body image and disordered eating specialist Harriet Frew shares 9 ways counselling can help

  • If you would like to address an eating disorder and need professional support, find a therapist here

You might feel dubious about how therapy could help you overcome an eating disorder. Perhaps the eating disorder feels entrenched into your identity and losing it would feel like losing a life-long friend? Maybe you have fears about change and feel anxious when considering a life without it? How can a counsellor possibly help you untangle this complicated relationship you have with the eating disorder? These can be real and common anxieties when someone is thinking about having therapy.


Here are 9 ways that therapy can help manage disordered eating


1.     Counselling can help you if you feel ambivalent about changing your habits

It is likely that you might feel in two minds about change. One part of you desperately wants to move on and let go of a destructive relationship with food and your body. However, another part of you just can’t. This can feel confusing as your feelings about the eating disorder might vary day-by-day or hour-by-hour. Your therapist can help you explore this ambivalence and recognise what the eating disorder means to you. Maybe it is a way of coping with difficult feelings? Maybe it is a way of trying to control your weight? Maybe it is deeply familiar and offers safety and reassurance? In therapy, you can gain greater understanding about your ambivalence, and this can put powerful building blocks in place for change.


2.     You can start to understand why you developed an eating disorder

There is not a simple cause and effect to developing an eating disorder. However, often a combination of different events and life experiences can trigger it. Your counsellor can help you explore this and develop understanding. You will be piecing together the parts of the jigsaw puzzle to gain some clarity.


3.     You will develop helpful self-awareness

Some therapists use diary tools to help you increase awareness of your eating patterns, feelings and thoughts, and how these affect one another. The diary can help you have a birds-eye view, looking down on your life. You begin to recognise triggers for bingeing or restricting, developing an understanding of your coping strategies. Awareness usually comes first, before change can occur.


4.     Your therapist can help you break free from the dieting mindset

When you have an eating disorder, foods will be seen as ‘good’ or ‘bad’ and your judgement around eating will be extreme. Although, this feels a way of exerting some control around food, in reality it often exacerbates bingeing or over-eating behaviours. Counselling can help you challenge this mindset, as you learn to think differently and develop a healthier relationship with food.


5.     Therapy can help you manage difficult emotions

Eating disorder behaviours are often a way of unconsciously dealing with difficult emotions. Through bingeing or restricting, you might feel temporary distraction or relief from your feelings. Counselling offers a safe place to explore these feelings without judgement. For mental wellbeing it is important to be able to deal with emotions effectively and to learn better coping strategies for when we feel distressed or anxious.


6.    Counselling will give you some much needed thinking space and mental clarity

With your mind channelling 60,000 thoughts a day and many being repetitive, you can understand the power of your thinking. When you have an eating disorder, you thoughts will be dominated by food, weight and shape concerns. You might also experience anxiety around these issues and your thoughts might feel wildly out of control. A therapist can help you work with your thoughts, firstly to develop awareness of them; and then to be more accepting of these, as just thoughts. You can also be taught to challenge unhelpful thoughts with more rational alternatives.


7.     In therapy, you can develop self-compassion and healthy body image

Your body image is likely to be negative if you have an eating disorder. You might strongly dislike your body and feel uncomfortable with it. Therapy can help you improve body image. You can actively learn to develop a kinder relationship towards your body so achieving some self-acceptance. You can learn to appreciate and value your body for its strength and mobility, rather than judging it harshly based on aesthetics. 


8.     You will discover new ways to boost self-esteem and self-worth

If you have an eating disorder, your self-worth will likely be predominantly based on your body shape or weight. When you are doing ‘well’ you will feel good (or a bit better) about your body. When you are feeling out of control with food, you may feel guilty, anxious and ashamed. Your therapist can help you to value yourself for more than your body size. This may be hard at first, as you are possibly your own worst critic; and you may have relied on manipulation of your weight as a way of boosting self-esteem. Beginning to value yourself for your many other attributes and to be kinder in your self-evaluation, allows self-esteem to be slowly re-built.


9.     If you relapse, your therapist will be there to help you

It is unlikely that you will just wake up one day and say goodbye to the eating disorder once and for all. Change takes time and often you will fall down many times along the recovery road. Relapse is part of the process and provides a valuable opportunity for learning, building resilience and awareness. Your counsellor can help you manage relapse and also support you in identifying triggers for this.


It is possible to change and to recover from an eating disorder. The road will not always be smooth and there will be many inevitable bumps on the journey. However, it is worth taking the courageous step to reach out and have counselling. Letting go of an eating disorder can be about finding yourself again and engaging more fully with life. 

Harriet Frew is a verified welldoing.org therapist in Cambridge

Further reading

Misconceptions around eating disorders make my recovery harder

A celebration of appetite and eating

Breaking the diet-binge cycle

The rise of eating disorders in men

Why I wrote the story of my eating disorder