Eating Disorders...Not About the Food?

I’m constantly hearing from women struggling with food issues:

  • “If I could just stop eating so much...”

  • “If I could just eat more food and not hate myself so much after...”

Even those closest to them think it’s about the food:

  • “You just need to eat!!” or “Just eat a burger!” (personal note: it really pisses me off when people say this to my clients who are struggling with restricting food)

  • “Maybe if you went on Weight Watchers you wouldn’t binge” (another personal note: prescribing weight loss programs to someone struggling with food issues only exacerbates the problem…future blog post for sure!!)

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If Not Food, Then What

The Internal Dialogue

“I will be worthy of love when I lose 10 pounds”

“People would like me and take me seriously if I was thinner”

“My eating disorder is my friend”

From the very first session in therapy I am working with my clients to identify what Carolyn Costin calls the Eating Disorder Self and the Healthy Self. The examples above are typical statements I hear from a clients’ Eating Disorder Self. Over time in counseling I help clients nurture and build up their Healthy Self until it is more dominating in the internal dialogue than the Eating Disorder Self. This is hard work because many clients come in unable to hear, or connect with, their Healthy Self. This is frustrating, exhausting, and challenging work, but it’s necessary. When a client is able to say something like, “The number on the scale does not dictate my worthiness”…we celebrate the Healthy Self!

Black and White (Dichotomous) Thinking

Thin is good and fat is bad

Hungry is good and full is bad

This food is good, but that food is bad

Black and white thinking can negatively influence the way people view themselves and their life. I compare black and white thinking to a light switch, where there is only an on and off, but life is so much more dynamic than on and off. Life is more like a dimmer switch. In session with me one thing I say a lot is ‘let’s not be a light switch, be a dimmer switch instead’. In DBT (Dialectical Behavior Therapy, a treatment approach derived from Cognitive Behavioral Therapy) people are asked to take a both/and approach instead of an either/or. A good example of this is a meal that doesn’t quite meet your expectations. Have you ever been out to eat somewhere or made something at home that didn’t taste as good as you wanted it to, but it still satisfied your hunger and gave your body the energy it needed. The meal was BOTH satisfying AND disappointing. Another non-food related example is a funeral where you are incredibly sad, but also reuniting with family you haven’t seen in years and sharing funny stories about the person you lost. Funerals are BOTH incredibly sad events AND can be filled with laughter, joy and the celebration of someone’s life.


At a surface level people are trying to control the way they look through food, exercise, purging, etc. On a deeper level they are trying to control their emotions. In session I have my clients dive deep to try and uncover what it is they are trying to change or avoid. This is not easy work to do. Most of the women who come to me have spent years building up thick, strong walls to keep feelings of fear, shame, and guilt locked up tight. That’s why we don’t jump in here from the start. It’s easier to begin with behaviors and thoughts and move to the more difficult stuff once trust is built between the client and myself. I want to make sure my clients feel safe because being vulnerable for these women is scary, and I respect that.

There's More!

This is not an exhaustive list. Easily I could add to this list with things like inappropriate coping mechanisms, self-esteem, self-hatred, and societal pressures to look like photoshopped images. 

Eating disorders are affected by a person’s biology, psychology, socio-cultural factors, and family influences. Each person is unique and therefore the factors that led to their relationship with food are unique. This list is just a few examples of how it’s not about the food, except it is about the food too. Sign up on my mailing list at to read my upcoming blog post It’s Also About the Food.

If you are in the Vancouver, WA or Portland, OR areas and struggling with an eating disorder, or think you might be, you can read more about how I can help here. Sign up for a free 15-minute phone consultation. I’d like to hear about what is happening with you and see if I can be of assistance or help direct you to the right person.