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I. What’s it like to get eating disorder therapy?

The three most common types of eating disorders that you might seek therapy for are anorexia nervosa, bulimia nervosa, and binge eating. Therapy may also help with avoidant/restrictive food intake disorder, a more recently defined eating disorder. You may also have underlying mental health issues combined with your eating disorder, such as depression, anxiety, or a substance use disorder. Therapy can help with these co-occurring conditions, as well.

When you become so preoccupied with food and body weight that it interferes with other aspects of your life, it may be time to seek an eating disorder therapist near you. Warning signs that you might need therapy may be physical or behavioral. Physical signs can include extreme weight loss, severe stomach issues, long-term constipation, hair loss, chronic fatigue, cessation of menstrual cycles, fainting, and/or growth of excessive body hair. Behavioral signs could include starving yourself, purging, compulsive exercising, and/or overusing diuretics or laxatives.

Eating disorders are very complex, and without treatment, they can take over your life and lead to serious, possibly fatal medical complications, including brain damage and multi-organ failure. Anorexia has the highest death rate of any mental disorder. Suicide is also common among individuals with eating disorders.

Psychotherapy is the most prevalent treatment for eating disorders and has been proven effective in helping address what led to the eating disorder. The therapy used varies based on the type and severity of the eating disorder and which treatment approach is most effective for you personally. Although there aren’t any specific medications to treat eating disorders, medicines that treat co-occurring issues or help with side effects may be used. Nutritional rehabilitation is also important, and supportive group therapy and self-help groups may provide ongoing support to prevent and treat relapses.

II. How to find an eating disorder therapist

Finding an eating disorder therapist near you that’s a good fit is vital to ensure you can build rapport and trust. What you discuss during therapy is often deeply personal, so you must feel comfortable with your therapist and have confidence in their ability to help you. Schedule a preliminary conversation with each potential therapist you identify to learn how your treatment would proceed and determine whether you’d feel comfortable opening up to them.

Demographics can play a big role in the eating disorder therapist you feel most relaxed with. You may be able to talk more openly with a therapist who’s the same or opposite sex as you, or you may prefer a therapist who’s the same age or older than you. Your comfort level may hinge on finding a therapist with a similar religious, ethnic, or cultural background or who’s sensitive to an LGBTQ identity.

Therapists have different professional backgrounds and specialties, so look for someone with expertise in the field of eating disorders. The best therapists also have the appropriate education, training, certification, and licensure. State-mandated qualifications for psychotherapists are typically rigorous to ensure they provide quality mental health care. Because these qualifications differ by state, be sure to check the specific licensing requirements in yours.

Don’t let cost deter you from getting much-needed therapy, but ensure you factor long-term per-session fees into your budget. Check your insurance policy to see if it will cover part of the cost and confirm that a potential eating disorder therapist near you is an in-network provider. If your insurance doesn’t cover mental health care, see if the therapist offers a sliding fee scale. Some therapists may offer teletherapy, which is online therapy that lets you attend sessions remotely, often at a lower cost.

III. What does eating disorder therapy help with?

Eating disorder therapy helps with various maladaptive eating behaviors and underlying issues causing these disorders. Common eating disorders therapy can help with include:

  • Anorexia nervosa: Characterized by avoiding food, severely restricting food, or only eating small quantities of certain foods. Sufferers may be dangerously underweight but still see themselves as overweight.
  • Bulimia nervosa: Characterized by repeated episodes of eating abnormally large amounts of food followed by forced vomiting to compensate for overeating. Sufferers also may overuse diuretics or laxatives, exercise excessively, and/or fast.
  • Binge eating disorder: Characterized by out of control, or binge, eating without the purging seen in bulimia. Sufferers are often overweight or obese and usually have feelings of shame, guilt, and distress.
  • Avoidant/restrictive food intake disorder: AFRID may involve sensory sensitivity that causes avoidance of specific foods due to texture, taste, or smell; low appetite/lack of interest in eating; and/or eating avoidance after a traumatic choking or vomiting experience.

IV. How can you prepare for eating disorder therapy?

Come to your first therapy session prepared with details that can help your therapist better understand the severity of your eating disorder and how long you’ve been dealing with it. Document any physical symptoms you’ve been experiencing that are likely caused by your eating disorder and any situations and/or feelings that trigger binge eating episodes. Also, write down what bothers you most about food, eating, and body weight, and why you have an aversion to eating and/or gaining weight.

V. What are common eating disorder therapy treatments?

Treatment plans for eating disorders often involve a combination of approaches, including psychotherapy, medical care, nutritional counseling, and/or medications. Common eating disorder therapy and treatment options include:

Cognitive behavioral therapy

CBT is one of the most established psychotherapies for bulimia and binge eating and targets distorted thoughts about food and maladaptive eating behaviors that maintain the eating disorder. When used for anorexics, therapists help them challenge their distortions concerning body image and develop accurate ways of viewing themselves. CBT helps interrupt patterns of restrictive dieting and binge eating through skills training, education, and anxiety reduction.

Interpersonal psychotherapy

IPT is also one of the most established psychotherapies for bulimia and binge eating and targets interpersonal difficulties that lead to negative emotions that maintain the eating disorder. During IPT sessions, you focus on coping with the frustration and tension resulting from negative interpersonal interactions while learning to improve your relationship skills.

Family-based therapy

FBT has stood out as an effective treatment for adolescents with anorexia and may be helpful for those with bulimia. Sometimes known as the Maudsley method, FBT is designed to enlist family support to ensure healthy eating patterns in anorexics, and it was modified to focus on interrupting binge eating and purging patterns in bulimics. Therapists may also set other goals, such as developing the communication skills to address conflict resolution.

Medication

Although there aren’t any medications that change thoughts or behaviors about food and body weight, there are medications that can treat underlying conditions and make treating an eating disorder easier. Antidepressants or mood stabilizers may help with co-occurring depression or anxiety but shouldn’t be used without therapy. However, using medications when treating anorexics and bulimics should be done with caution. Medications, especially antidepressants, can cause issues in malnourished individuals because they’re more prone to side effects.

VI. What else can help?

If you have severe physical complications and/or are extremely underweight, your therapy must be combined with care from medical providers. In severe cases, especially involving anorexia, a residential treatment facility or hospitalization may be required until you reach a minimally appropriate body weight. Wellness and nutrition counseling is also a must to help you return to a normal weight. You’ll learn to alter bad habits and incorrect beliefs concerning food, dieting, and exercise and develop healthy eating habits and meal planning. To prevent and treat relapses, supportive group therapy and self-help groups may help provide ongoing support.

VII. Sources

If you’d like more information about eating disorder therapy, check out the sources used for this guide.