Working with eating disorders

A person who is wasting away because they're afraid of weight gain is in great distress. Having a compulsion to eat and eat is a terrifying loss of control. Here's a look into some common eating disorders and how they affect sufferers:

Anorexia nervosa

People with anorexia nervosa reduce their food intake to lose weight. They are afraid of gaining weight and often have a distorted body image. Low-calorie meals may be planned and only eaten at particular times. With weight loss, there is tiredness and difficulty concentrating. Other symptoms include feeling cold, lack of menstrual periods in women, moodiness, secrecy and irritability. Extreme cases of starvation can be fatal.

Bulimia nervosa

People with bulimia nervosa have binging episodes which are sometimes planned in advance. More food than usual is eaten very quickly. Eating often becomes mechanical, uncontrolled and trance-like. Methods used to prevent weight gain include vomiting, taking laxatives and dieting. Weight may fluctuate but usually remains in the normal range. Symptoms include a sore throat, stomach bloating and loss of enamel from teeth. Frequent use of laxatives can cause spastic colon and other symptoms.

Binge-eating disorder 

People with binge-eating disorder will binge without purging (which is likely to cause weight gain).

Despite causing huge distress, worrying physical effects and eventually long-term physical damage, eating disorders have an important purpose. They help sufferers to cope with many underlying issues, for example, abuse, bereavement, low self-esteem, fears relating to growing up and separating from parents, feelings of not fitting or belonging, an uncertain sense of identity and feelings of inner emptiness.

Food can have many meanings and uses. It may be used to anesthetised emotional pain and to fill up emotional and spiritual emptiness, difficult feelings may be swallowed. Starvation can be an attempt to be in control, it may be a way of punishing oneself or an endeavour to be perfect. People may starve in the hope of being accepted and loved. They can be influenced by cultural ideas of beauty and perfection promoted by the media.

People are not always consciously aware of their underlying issues. If their eating disorder were to magically disappear these issues might cause difficult feelings such as anger, fear and loneliness. They may become depressed and they may find other ways of coping, from self-harm and addictions to drugs and alcohol.

What is person-centred counselling and how can it help?

Person-centred counselling is non-directive and at the client’s pace. Giving up unhealthy eating behaviours is within the client’s control, therefore, the risk of eating disorders being replaced by other damaging behaviours can be reduced.

Eating disorders are isolating with secret binging and time-consuming obsessions such as counting calories, planning meals and exercising. At the start of counselling clients often feel that others do not understand them, do not see their inner pain and judge them for losing or gaining weight.

A person-centred counsellor is empathic and understands at a deep level from the client’s point of view. This is likely to reduce feelings of isolation and loneliness. Clients are accepted as they are without judgment.

It is essential that counsellors are trustworthy. Person-centred counselling is relational with counsellors seeking to form caring and supportive relationships with their clients. Practitioners are sincere, honest and genuine.

Counselling can enable clients to make changes:

  • Clients gain awareness and understandings of their underlying issues.
  • Clients can think about improving their situation and how to nurture and take care of themselves physically and emotionally.
  • Clients can develop a more healthy relationship with food.
  • Clients are likely to gain self-confidence and self-esteem.

Clients make decisions when they are ready to do so. A decision which others consider small such as adding another vegetable to one’s diet can be huge and courageous. As they become stronger clients may choose to make lifestyle changes, for example, a new and more satisfying career.


It is important to explain that recovering from an eating disorder is rarely a quick or easy process. Changes do not happen in neat stages. At times clients may feel worse rather than better, improvements may be followed by lapses.

As difficult feelings emerge the counsellor is supportive, helping clients to face and to make sense of whatever they are experiencing. Person-centred counsellors trust that their clients can recover and develop psychologically.

Relatives and friends 

Close relatives and friends are often affected. They may become extremely anxious, confused and uncertain about how to help. Counselling for relatives and friends helps them to gain their own insights and to feel more relaxed so that they are in a better position to be supportive.

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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Stanmore HA7 & Harrow HA3

Written by Paula Newman

Stanmore HA7 & Harrow HA3

I have been counselling and supervising for several years and am experienced in providing individual, couples and family therapy. Counselling can be a journey of discovery, it can also be challenging and emotional, it is my intention to provide a safe, supportive and confidential relationship. I am...

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