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Eating disorders (or ED) are, unfortunately, more common than we may know. The National Association of Anorexia Nervosa and Associated Disorders approximates nearly 30 million Americans live with an eating disorder during their lifetime. And while eating disorders can have a plethora of causes unrelated to body image – from genetics and environment to PTSD and abuse – the disorders themselves have a massive impact on patients, and are among the deadliest of mental illnesses.
ED therapists, clinicians, and specialists work with patients to make a healthy eating disorder recovery. Though ED recovery is an uphill battle, people on an eating disorder treatment team work to develop healthy eating habits and reach a healthy weight with their patient. What is an eating disorder therapist, and what do you need to do as a mental health professional to help treat patients suffering from an eating disorder?
ED is a complicated issue to tackle. The root causes of eating disorders doesn’t always have a connection to food itself, but are is still related to intuitive eating. Anorexia Nervosa, which involves limiting food intake and restricting calories, has more to do with an intense fear of gaining weight compared to Bulimia Nervosa, where the disorder manifests itself through binge eating followed by self-induced vomiting, excessive exercise, laxative overuse, or fasting. Anorexia Athletica results in compulsive exercise, whereas Binge Eating Disorder is about regularly consuming excessive quantities of food, then feeling physical or mental anguish.
Body Dysmorphic Disorder (BDD) involves obsessing over body image, an imaginary defect in physical appearance, or being extremely concerned over a slight physical blemish others may not notice. Pica involves eating substances with no nutritional value, like paper, hair, ice, or clay for over a month. Rumination Disorder presents itself as regurgitation and rechewing food, whereas Avoidance or Restrictive Food Intake Disorder symptoms see patients have an extreme lack of interest in eating or distaste for many foods, while Orthorexia is an extreme fixation on eating healthy foods. Night-eating syndrome or “sleep eating” is when patients continually eat throughout the evening or eat in their sleep.
As you can see, the eating disorder umbrella includes many different types of disorders – and not all are related to weight. That’s why it’s important to know the ins and outs of these ED variations in order to give the patient the best course of treatment.
ED therapists help their patients through the process of recovering from an eating disorder. Treating these disorders can be similar to treating obsessive-compulsive disorder (OCD), anxiety, or depression. While doctors work to treat the physical aspects of an eating disorder, such as electrolyte imbalance, eating disorder therapists often work with other psychotherapy counselors or social workers. Regardless, it’s more likely an ED therapist would work with a team of mental health professionals, medical specialists, and registered dietitians to observe, monitor, and care for the patient, depending on the severity of the disorder.
They may use evidence-based treatments like cognitive behavioral therapy (CBT) or dialectical behavior therapy to reduce and eliminate behavioral patterns related to food and eating. ED therapists can do this through individual sessions, family therapy, or group therapy sessions. Learning about the differences between CBT and psychodynamic therapy can also help aspiring ED therapists. Much like other patients suffering from mental health issues, patients recovering from an eating disorder need their therapists to work on developing coping strategies, make treatment plan changes as necessary, and collaborate on goals together.
There aren't a lot of master’s programs focused specifically on eating disorders. But given what this line of work requires, it’s imperative that ED therapists study abnormal psychology, body image issues, personality disorders, and psychoanalytic therapy before taking on clients. Prepare for this part of a therapy career by looking for opportunities to work in clinics where ED is treated, or working specifically with ED patients during supervised sessions.
While it’s not absolutely required for ED therapy, it helps to know that eating disorders are tricky, both for the patient and people around them. Beyond empathy, ED therapists need to have a firmer hand, since many eating disorder treatments need patients to follow strict boundaries. Having at least some previous experience working with patients with depression, anxiety, PTSD, sexual assault, or abuse also helps, since these issues usually also show up in the work of treating an eating disorder.
If you’re used to treating patients with anxiety, for example, but want to expand your knowledge base and start taking on eating disorder patients, certification can help. However, right now there is only one nationally recognized organization offering certification credentials – IAEDP, or the International Association of Eating Disorders Professionals. To get certified, you’ll need to complete 2,500 hours of supervised patient care and a case study, along with finishing four core courses and passing exams covering different types of eating disorders, medical treatments, therapy treatments, and nutrition therapy.
Though some therapists feel they should keep strong, strict boundaries between their personal experiences and that of their clients, other therapists feel that depending on the circumstances, sharing their personal history could help their patients – and this is especially true for eating disorders. If a patient sees a recovered person in front of them, it could help guide the patient towards recovery. That said, just like any patient, no two people are the same. Just because you were able to recover doesn’t mean they can or want to, so you would need to accept the fact that as a therapist, it is a difficult field with many patients resistant or outright hostile to treatment. And even if patients do recover, there is always the possibility of a relapse. Maintaining a relationship with patients is crucial in both online and in person counseling, but can be a bit harder to maintain as an online therapist. Read up on the pros and cons of online counseling before making a decision on how you’d like to run your practice.
While research shows that a lot of folks who are specialists in treating eating disorders have struggled with ED themselves, there’s no proof or outright rule that says personal experience will make a person more or less effective at this job. So if you have personally struggled with disordered eating in the past, you may want to reconsider doing this work. Therapists with their own history of ED could get triggered by working with patients, or lack the objectivity needed to treat their patients. On the other hand, if you’ve recovered from ED, as an ED therapist, you might have an easier time working with patients and be able to relate to patients on their level in a way other clinicians and specialists may not.
In the end, working with eating disorder patients is demanding, difficult work. Yet the rewards for helping patients reach recovery are beyond measure. Think through all the possibilities, and if it sounds right to you, contact us today and consider working in this particular field, and treating patients with a uniquely common yet often misunderstood mental health issue.
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