Eating Disorders & Body Image

Eating disorders are among the most complex and dangerous mental health conditions, with the highest mortality rate of any psychiatric diagnosis. And yet they remain profoundly misunderstood — often dismissed as vanity, dieting gone too far, or attention-seeking. In reality, eating disorders are sophisticated psychological adaptations: ways of managing emotional pain, asserting control in situations that feel chaotic, coping with trauma, or navigating the crushing demands of living in a culture that is obsessed with bodies and weight. Recovery requires addressing all of these layers, not just the relationship with food.

Types of Eating Disorders

• Anorexia nervosa: restriction of food intake, intense fear of weight gain, distorted body image
• Bulimia nervosa: cycles of bingeing and purging, driven by shame and the need for control
• Binge eating disorder: recurrent episodes of bingeing without compensatory behaviors
• ARFID (Avoidant/Restrictive Food Intake Disorder): restricted eating based on sensory or anxiety concerns
• Orthorexia: obsessive focus on "healthy" or "clean" eating that becomes rigid and controlling
• Body dysmorphia: distressing preoccupation with perceived flaws in appearance

The Role of Culture and Identity

Eating disorders develop within a cultural context that pathologizes certain bodies and glorifies others — and that messaging is absorbed from a young age. People of all genders, all bodies, all backgrounds develop eating disorders, though they are underdiagnosed in men, people of color, and people in larger bodies. LGBTQ+ individuals face elevated rates of disordered eating, often linked to minority stress, body dysmorphia related to gender dysphoria, and the particular body culture in some queer communities. A trauma-informed approach to eating disorders must address cultural context alongside personal history.

Treatment and Recovery

Recovery from an eating disorder is a nonlinear process that takes time and sustained support. Effective treatment addresses the psychological, relational, and often somatic dimensions of the disorder alongside nutritional recovery. DBT skills help with the emotional dysregulation that drives disordered eating patterns. IFS approaches the eating disorder as a protective part with its own internal logic and needs. Body-based approaches help rebuild a safer relationship with embodiment. Recovery is not just about food — it's about building a life where you no longer need the eating disorder to survive.