Support around food, body image and the thinking behind them

What it can look like

Eating disorders do not have one look or one body type. For some people the struggle centers on strict rules about what, when and how much to eat. For others it is a cycle of holding back and then eating past fullness, followed by guilt. It can show up as constant counting, checking the mirror, avoiding meals with other people, or exercising to make up for food. Often there is a sharp inner voice keeping score.

None of this is about vanity or willpower. Eating behaviors can become a way of managing something else, such as anxiety, a need for control, or feelings that are hard to name. Understanding what the behavior is doing for you is part of loosening the hold it has.

• Rules around food: Lists of allowed and forbidden foods that keep getting longer.
• Body checking: Weighing, measuring or mirror checks that never quite settle the worry.
• Eating with others: Avoiding shared meals, events, or questions about what is on your plate.
• Guilt and shame: A harsh inner voice that grades every meal and every day.

Why medical care is part of the picture

Eating disorders can affect physical health, sometimes in ways that are not visible from the outside. That is why counseling here works alongside medical care rather than replacing it. Regular check-ins with a physician are part of keeping you safe, and diagnosis and medication sit with medical providers.

This is outpatient counseling. If you ever need a higher level of care or a medical assessment, I will say so plainly and help you find it. Saying that out loud is not a judgment about you. It is part of taking the problem seriously.

How the work is approached

We go at a pace you set. Early sessions focus on understanding your particular pattern: what tends to set it off, what it seems to protect you from, and where things are already a little easier. From there, skills come in where they fit. DBT skills can help with urges and the emotions that drive them. CBT looks at the rules and predictions that keep the pattern in place. ACT helps you act on what matters even when anxious thoughts about food or your body show up.

Body image gets its own attention. The running commentary about how you look can overlap with a low sense of worth, and the self-esteem page describes how that part of the work goes. Worry can travel alongside eating struggles too, which the anxiety therapy page covers.

Teens and families

Eating struggles can begin in the teen years. For anyone under eighteen, a parent or guardian is part of the process. Early on we agree what gets shared with parents and what stays private, so your teen can be honest while you stay informed about anything affecting their safety. The teen therapy page explains more, and family sessions are an option when the household wants to support change together.

If you need help now

Psi Wellness is not a crisis service. In an emergency, call 911, or call or text 988, or text HOME to 741741. The crisis resources page has more detail. The full range of concerns seen in the practice is on what I treat.

Common questions