How Can Counselling Help with my Eating Issues?

If you’re struggling with eating issues, know that you don’t have to face them alone.

Counselling offers a safe, non-judgmental space where you can explore the underlying causes of your eating issues to help you create a better relationship with food and yourself. A skilled therapist can help you understand the connection between your emotions, thoughts, and behaviours related to food.

Remember, seeking help is a sign of strength, not weakness. Taking the first step towards counselling could be the beginning of a positive transformation in your life.

Now, the burning question. Can counselling really help with my eating issues? Let's have a look together at the current evidence-based research!

What Counselling Can Do

1. Creating a Safe, Non-judgmental Space

When dealing with eating issues, feelings of shame, guilt, or fear often arise. During counselling sessions, you are met with unconditional positive regard, meaning your therapist accepts you without judgment, regardless of your struggles. This safe space allows you to open up about your relationship with food, eating habits, and body image, knowing that you will be heard and understood.

Evidence-based research found that women with a diagnosis of Anorexia Nervosa reported highly valuing being listened to and having had a directive yet warm and respectful counsellor [1]. Similarly, congruence (genuineness) from the therapist has been seen as instrumental in the clients' progress, with this trust, openness and curiosity from the counsellor that enables clients to feel understood [2].

2. Deepening your Self-Awareness

Eating issues often involve a disconnection from your true self—perhaps driven by societal pressures, past trauma, upbringing, or internalised beliefs about food and body image. Counselling can encourage you to reconnect with your authentic self.

Person-centred counselling, for example, is grounded in the belief that you are the expert on your own life. Your therapist’s role is not to give advice or prescribe solutions but to support you as you explore the root causes of your eating issues. Through reflective listening and open dialogue, you are empowered to gain deeper insights into how your emotions, experiences, and self-perceptions influence your eating behaviours.

One of the steps in counselling is uncovering the root causes of your eating issues. Through compassionate and insightful conversations, your therapist will help you identify patterns, triggers, and past experiences that may be influencing your current relationship with food. This self-awareness is crucial for making lasting changes.

Clients with eating disorders have reported in research studies feeling appreciative of their counsellor's balance for direction and encouragement to self-discover [2].

3. Encouraging Emotional Exploration and Healing

In counselling, emotions can be seen as an essential part of your healing journey. Whether you turn to/away from food for comfort, control, or as a way to numb difficult feelings, your therapist will help you explore these emotions in a supportive environment. By expressing and understanding your feelings, you can begin to heal emotional wounds that may be at the core of your eating issues.

Evidence-based research has found that clients value the individualistic nature of counselling and appreciate the push to self-actualise; aspects of therapy that enable them to realise that they are more than just their eating disorder [2].

4. Building a Positive Self-Image

A positive relationship with food can sometimes be closely tied to how you view yourself. Person-centred counseling helps you develop a more compassionate and balanced self-concept. As you work through therapy, you’ll hopefully begin to shift away from negative self-judgements related to food and body image, and towards a view of yourself that is grounded in self-worth and self-respect.

5. Alleviating your Eating Disorder Symptoms

Person-centred counselling has been found to be effective in helping alleviate eating disorder symptoms [3]. 84% of participants no longer met the criteria for diagnosis of bulimia nervosa after undertaking counselling, with great improvements to their eating disorder.

The person-centred approach was also found to be linked to positive outcomes for young people suffering from an eating disorder [4]. Young people and their caregivers reported that therapy improved their mood and confidence, they noticed a reduction in behaviours related to the eating disorders, and found constructive changes in mindset. The young people particularly liked that they had a confidential space to speak freely and a strong relationship with their counsellor. These studies suggest that the approach is not only well-received by clients by also effective in supporting them.

Other empirically supported psychotherapies for eating disorders include cognitive behavioural therapy (CBT), ED-focused enhanced CBT (E-CBT), family-based therapy, and interpersonal psychotherapy (IPT) [5, 6, 7]. There is emerging evidence for the efficacy of other psychotherapies, including dialectical behavioural therapy (DBT), acceptance and commitment therapy (ACT) and integrative psychotherapeutic approaches [8, 9, 10, 11, 12].

What Counselling Cannot Do

While counselling can be an invaluable resource in addressing eating issues, it's important to understand its limitations.

Counsellors and therapists are not medical professionals, so they cannot monitor or manage the physiological aspects of eating disorders or other medical conditions related to food. This means they cannot diagnose medical conditions, prescribe medication, or monitor changes in your physical health, such as weight, nutritional deficiencies, or other medical complications. If you require medical supervision, it's crucial to work with a healthcare provider, such as a doctor and/or a nutritionist, alongside your counselling sessions [1].

The therapist’s role is to provide emotional and psychological support, helping you explore and resolve the underlying issues contributing to your eating behaviours, but they should work in collaboration with medical professionals to ensure a comprehensive approach to your well-being.

Where can I find further help (UK)? 

BEAT Eating Disorders

Helplines open Monday to Friday from 3pm to 8pm.

England: 0808 801 0677

Scotland: 0808 801 0432

Wales: 0808 801 0433

Northern Ireland: 0808 801 0434

Local support: https://www.beateatingdisorders.org.uk/get-information-and-support/beat-support-in-my-area/

Website: https://www.beateatingdisorders.org.uk/

Talk ED

Advice and support for anyone affected by eating problems.

talk-ed.org.uk

Samaritans

Helpline: 116 123

Website: samaritans.org

Samaritans are open 24/7 for anyone who needs to talk.

If you are in need of urgent help for yourself or someone else, please contact 999 or 111 option 2.

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I am open to new clients! 

I specialise in eating issues. Get in touch to book a free phone consultation or an initial session.

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References

[1] Marchant, L., & Payne, H. (2002). The experience of counselling for female clients with anorexia nervosa: A person- centred perspective. Counselling and Psychotheraphy Research, 2(2), 127–132.

[2] Lefebvre, D. B. (2016). Client perspectives of psychotherapy for eating disorders in community practice settings (Doctoral dissertation,Université d'Ottawa/University of Ottawa).

[3] Schützmann, K., Schützmann, M., & Eckert, J. (2010). Wirksamkeitvon ambulanter Gesprächs psychotherapie bei Bulimia nervosa: Ergebnisse einer randomisiert- kontrollierten Studie. Psychotherapie, Psychosomatik, Medizinische Psychologie, 60, 52–63.

[4] Ward, S., Daughtrey, N., Constable, C. and Bel, J., (2024). Exploring young people with eating difficulties and their caregivers' experiences of person-centred counselling. Couns Psychother Res., 24, 1120–1132.

[5] Heruc, G., Hurst, K., Casey, A., Fleming, K., et al. (2020). ANZAED eating disorder treatment principles and general clinical practice and training standards. J Eat Disord., 8(1), 63.

[6] Hay, P. (2013). A systematic review of evidence for psychological treatments in eating disorders: 2005–2012. Int J Eat Disord., 46(5), 462–9

[7] Hilbert, A., Petrof, D., Herpertz, S., Pietrowsky, R., et al. (2019). Meta-analysis of the efcacy of psychological and medical treatments for binge-eating disorder. J Consult Clin Psychol., 87(1), 91–105.

[8] Pisetsky, E. M., Schaefer, L. M., Wonderlich, S. A., Peterson, C. B., (2019). Emerging psychological treatments in eating disorders. Psychiatr Clin North Am., 42(2), 219–29.

[9] Linardon, J., Fairburn, C. G., Fitzsimmons-Craft, E. E., Wilfey, D. E., Brennan, L., (2017). The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: a systematic review. Clin Psychol Rev., 58,125–40.

[10] Fogelkvist, M., Gustafsson, S. A., Kjellin, L. and Parling, T., (2020). Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: a randomized controlled trial. Body Image, 32, 156–66.

[11] von Ranson, K. M., Wallace, L. M. and Stevenson, A., (2013). Psychotherapies provided for eating disorders by community clinicians: Infrequent use of evidence-based treatment. Psychother Res., 23(3), 333–43.

[12] Tone, J., Chelius, B. and Miller, Y. D., (2022). The effectiveness of a feminist-informed, individualised counselling intervention for the treatment of eating disorders: A case series study. Journal of Eating Disorders, 10:70.