Counseling for Eating Disorders

Eating Disorder Counseling as Treatment

Eating disorders can leave people feeling incredibly isolated and even lead to life-threatening health consequences if left untreated.

Unfortunately, eating disorders have high mortality rates due to the life-threatening conditions that can arise, so that treatment can become a matter of life or death.

The good news is that eating disorders are well-researched conditions, and people can fully recover with the proper counseling and support from loved ones.

Types of Counseling for Treating Eating Disorders

Eating disorders can be challenging to treat, as they can have very serious mental and physical health consequences. Regardless of the type of eating disorder and treatment plan, most people with eating disorders will undergo counseling as part of their treatment.

Because there are no one-size-fits-all approaches to treating eating disorders, patients have several options to choose from. Your doctor or mental healthcare professional can help determine which counseling best meets your unique needs.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, or CBT, is by far the most common type of counseling for many mental illnesses and has been shown to help, especially with bulimia nervosa. CBT works by helping patients learn to identify self-destructive thought patterns as they occur.

The goal is to develop strategies to address these negative thought patterns and redirect them into more positive or neutral ways of thinking about a situation.

For example, a patient with an eating disorder might learn to spot thoughts that lead to disordered eating habits and instead refocus them on coping strategies or methods to reach out to loved ones for help.

Dialectical Behavioral Therapy (DBT)

Dialectical behavioral therapy (DBT) is another common type of therapy that was first developed to treat borderline personality disorder.

Research from Temple University has since found DBT to help treat eating disorders, especially anorexia nervosa. DBT helps anorexia by improving interpersonal skills and strengthening openness and flexibility to combat the often rigid thinking in eating disorders.

DBT is typically conducted in a group setting and, instead of focusing on thought patterns, tends to focus more on changing behavioral patterns through self-reflection and learning to regulate intense emotions.

Interpersonal Psychotherapy (IPT)

Interpersonal psychotherapy, or IPT, has become a leading evidence-based treatment for eating disorders that feature binge eating, especially bulimia nervosa and binge eating disorder. IPT works by helping patients improve the interpersonal difficulties common in patients with eating disorders.

IPT typically lasts 12–16 weeks and focuses on improving and maintaining interpersonal skills with themselves and others. Patients work on resolving conflict within relationships that cause distress, loss, or grief and difficulties in starting or sustaining relationships that contribute to their disordered eating.

Family-Based Therapy (FBT)

Family-based therapy (FBT) effectively treats adolescents with anorexia and bulimia. FBT allows parents to take the lead in helping their child through eating disorder recovery.

A mental health clinician helps parents show their child empathy while enforcing strict rules about eating, choosing, preparing, and serving all of their child’s foods. The process typically happens in three phases.

The phases of FBT include:

• Phase 1: Parents are responsible for restoring weight, eliminating binge eating and purging, and establishing a regular eating pattern.
• Phase 2: The responsibility of eating is gradually handed back to the adolescent
• Phase 3: Parents and the clinician review the health of the adolescent and assess where the child is developmentally once the eating disorder has receded.

Nutrition Counseling

Nutrition counseling typically involves working with a registered dietitian with training in eating disorders. Many patients with eating disorders have a warped view of their body image, body weight, and the nutritional value of certain foods.

A dietitian can help patients improve their eating habits, develop nutritious meal plans, and establish more positive eating behaviors. For patients with malnutrition, nutrition counseling can also help focus on increasing electrolytes to avoid the risk of stroke or heart attack.

How Does Counseling Help With Eating Disorders?

Oftentimes, eating disorders can severely warp a person’s perception of health and body image, causing low self-esteem and highly destructive eating patterns.

What may seem obviously unhealthy to someone without an eating disorder can seem perfectly reasonable to someone with an eating disorder.

Counseling can help patients put their disordered eating behaviors into perspective, change how they view food and handle the negative thinking patterns leading to their eating disorder.

Counseling can also address any co-occurring mental health conditions or substance abuse issues.

Other benefits of counseling for eating disorders include:

• Better eating habits and a healthier relationship with food
• Improved interpersonal relationships with friends and family members
• Healthy weight gain for underweight individuals or weight loss for overweight individuals
• Quitting unhealthy dieting, overeating, purging, and laxative abuse
• Increased food intake
• Prevention of damaging health effects like osteoporosis, malnutrition, heart and brain damage, low blood pressure, or heart attack and stroke
• Improved self-esteem and body image

How to Find the Right Eating Disorder Counselor

Although finding the right eating disorder counselor for you or a loved one may seem impossible, many mental health professionals are ready to help patients work toward eating disorder recovery.

Here are some factors to consider when looking for an eating disorder counselor:

• Appointment time: Make sure the counselor offers appointment times that fit into your busy life, or you may be less likely to attend and commit to your recovery process.
• Experience: Just like with medical care for physical ailments, you want to work with a therapist with experience with eating disorders, so make sure the counselor you’re considering has the proper training to help you with your eating disorder.
• Comfort: Regardless of the counselor’s training, sometimes you don’t click with a person, and that’s okay—you can always try a different counselor if you don’t get along with someone. Ensuring you are comfortable and supported is essential for eating disorder recovery, so don’t be afraid to try someone new if a counselor doesn’t make you feel seen and respected.
• Out-of-pocket cost: People often cite financial costs as the most significant barrier to seeking treatment. Make sure you ask your counselor what the price of sessions is or check with your insurance company to determine your co-pays. You can also ask if any lower-cost community resources are available in your area.

Getting Counseling for Eating Disorders

If you or a loved one are ready to find a counselor for an eating disorder, there are a few places to start. You can begin by talking to your general doctor about treatment options or requesting a referral to a counselor.

Another option includes helplines, which can provide basic information about eating disorder treatments in your area. You can use the Eating Disorders Helpline offered by the National Association of Anorexia Nervosa and Associated Disorders (ANAD) or the National Eating Disorders Association Helpline.

You can also use the online treatment locator SAMHSA offers or call 1-800-662-4357 (HELP) to learn what outpatient treatment options are available in your area.