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Eating Disorder

Eating Disorder Counselling, Therapy and CBT in St Albans/Hertfordshire and Online

Many of us have concerns about our appearance, diet, and exercise habits. These concerns are often influenced by the media, which bombards us with messages about healthy eating, dieting, exercise, and beauty standards. We are constantly exposed to images of thin and attractive individuals, which can intensify these concerns. However, when these concerns, especially those related to weight and shape, begin to profoundly affect a person's life, it may indicate the presence of an eating disorder. Eating disorders are characterised by a significant negative impact on various aspects of a person's life due to their preoccupation with weight, shape, and related issues.

What are the Symptoms of Eating Difficulties?

Eating disorders encompass a range of difficulties related to eating habits. These may involve patterns such as restricting food intake, adhering to strict dietary rules, engaging in episodes of binge eating, constantly preoccupying oneself with food, and resorting to vomiting after eating. In addition, individuals with eating disorders may develop an excessive and obsessive relationship with exercise, feeling intense guilt if they are unable to engage in physical activity. Other behaviors that can be associated with eating disorders include the misuse of laxatives and diuretics.

These problematic eating habits and behaviors can have far-reaching consequences on all aspects of a person's life. They can lead to social withdrawal, emotional challenges such as anxiety and depression, and have a detrimental impact on a person's physical well-being in both the short and long term. In severe cases, eating disorders can even result in fatal outcomes. If you suspect that you are experiencing difficulties with eating, it is strongly advised to consult your General Practitioner (G.P.) to assess your physical well-being.

Types of Eating Disorders

There are several specific eating disorder diagnoses that are commonly recognised:

  1. Anorexia Nervosa:

  • Restricting the amount and types of food consumed

  • Engaging in excessive exercise

  • Intense fear of gaining weight, with an ideal weight/shape significantly below what is considered healthy

  • Being significantly underweight, typically with a Body Mass Index (BMI) below 17.5

  • Experiencing significant weight loss

  • Distorted perception of body size, often seeing oneself as larger than reality

   2.  Bulimia Nervosa:

  • Recurrent episodes of binge eating, characterised by consuming a large amount of food within a discrete period and feeling a loss of control

  • Engaging in compensatory behaviors to prevent weight gain, such as vomiting, excessive exercise, use of laxatives or diuretics, or extreme dieting

  • Self-worth largely influenced by body weight and shape


   3. Binge Eating Disorder:

  • Regularly consuming large quantities of food, often rapidly and beyond the point of feeling comfortably full

  • Frequently eating in secrecy or feeling a lack of control over eating

  • Experiencing feelings of guilt, shame, or distress associated with the binge eating episodes


In addition to these specific eating disorder diagnoses, there are cases where individuals may exhibit eating-related difficulties that do not fit into these categories precisely. These instances are classified as Eating Disorders Not Otherwise Specified (EDNOS) or Other Specified Feeding and Eating Disorders (OSFED).

What Causes Eating Difficulties?

The exact causes of eating difficulties are not fully understood. However, it is believed that a combination of biological, psychological, and environmental factors contribute to their development.


Biological factors that may play a role include:

  • Genetic predisposition: Certain genes may increase the vulnerability to developing an eating disorder.

  • Brain chemistry: Imbalances in neurotransmitters involved in mood regulation and appetite control may contribute to the development of eating difficulties.

  • Hormonal factors: Hormonal disruptions which are involved in hunger and satiety signals, can impact eating behaviours.

Psychological factors that can contribute to eating difficulties include:

  • Low self-esteem: Negative self-perception and a distorted body image can influence the development and maintenance of disordered eating patterns.

  • Perfectionism: Having excessively high standards for oneself and striving for perfection can contribute to a preoccupation with weight, shape, and food.

  • Need for control: An intense desire to have control over one's life, emotions, and body can manifest in restrictive eating behaviors or other disordered eating patterns.

  • High stress levels: Stressful life events or chronic stress can trigger or exacerbate disordered eating behaviors as a way to cope or regain a sense of control.


Environmental factors that may contribute to eating difficulties include:

  • Dysfunctional family dynamics: Family environments characterised by conflict, criticism, or overemphasis on appearance can contribute to the development of disordered eating patterns.

  • Childhood trauma: Experiences of abuse, neglect, or other forms of trauma during childhood can increase the risk of developing eating difficulties later in life.

  • Societal pressures: Cultural and societal ideals that prioritise thinness and equate appearance with worth can create pressure to conform to unrealistic beauty standards, which may contribute to disordered eating behaviors.

These factors interact in complex ways, and their influence can vary among individuals. It's important to approach the understanding and treatment of eating difficulties from a holistic perspective that takes into account the interplay of these factors.

When Should I Get Help For Eating Difficulties?

Overcoming an eating difficulty can be a challenging journey, and trying to navigate it alone may not be effective or sustainable. The impact of an eating difficulty extends beyond the surface and can significantly affect various aspects of your life, both emotionally and physically. Recognising the need for support and seeking help is an important step towards recovery.

Reaching out for help is an essential step in your journey towards recovery. Seeking support from a therapist experienced in treating eating difficulties, can provide you with the guidance, expertise, and resources needed to address the underlying issues and develop healthier relationships with food, body, and self.


Remember, you don't have to face this challenge alone. Seeking help is a brave and empowering decision that can lead you towards a path of healing, improved well-being, and a healthier relationship with yourself and food.

Treatment for Eating Difficulties

Psychological therapies play a crucial role in the treatment of various types of eating difficulties. Through therapy, you will embark on a journey of understanding your challenges, exploring their underlying causes and factors that contribute to their persistence. Along the way, you will learn a range of effective coping strategies to overcome these difficulties and promote lasting change.

One widely recommended approach for eating difficulties is Cognitive Behavioural Therapy for Eating Difficulties (CBT-E). This specialised form of CBT is tailored specifically to address the complexities of disordered eating. In CBT-E, you will receive supportive guidance to make positive changes to your eating habits, challenge unhelpful thoughts and beliefs, and work towards improving your mood, self-esteem, and body image.

In addition to CBT-E, other therapeutic approaches have also demonstrated effectiveness in treating eating difficulties. For instance, Dialectical Behavioural Therapy (DBT) has shown promise in helping individuals with Bulimia Nervosa. DBT focuses on developing skills for emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness, providing comprehensive support in managing eating difficulties and related emotional challenges.


It is important to note that therapy is not a one-size-fits-all approach, and the specific therapy model used will be tailored to your unique needs and circumstances. Your therapist will collaborate with you to determine the most suitable therapeutic approach, considering your specific eating difficulties, goals, and preferences.


Therapy provides a safe and supportive environment for exploring and addressing the complexities of eating difficulties. By engaging in therapy, you are taking an important step towards recovery, gaining valuable insights, and acquiring the skills and tools needed to foster a healthier relationship with food, body, and self.

What are the Benefits of Therapy for Eating Difficulties?

Extensive research and our own clinical observations consistently demonstrate the positive impact of therapy in treating eating difficulties. Engaging in therapy can bring about a range of significant improvements, including:

  • Reduction in disordered eating behaviors: Therapy provides effective strategies and support to help individuals develop healthier eating habits, reduce destructive behaviors such as bingeing or purging, and establish a more balanced relationship with food.

  • Decreased concerns about weight, shape, and food: Through therapy, individuals can challenge and modify negative beliefs and distorted thinking patterns associated with body image and weight. This can lead to a decrease in preoccupation with these concerns and a shift toward a more positive and accepting mindset.

  • Enhanced self-esteem, mood, and emotional well-being: Therapy addresses underlying factors contributing to low self-esteem and emotional distress related to eating difficulties. By working through these issues, individuals can experience improved self-worth, greater emotional resilience, and a reduction in symptoms of anxiety and stress.

  • Improved body image: Therapy provides a platform for exploring and reshaping one's perception of their body. Through targeted interventions, individuals can develop a more compassionate and realistic view of their body, fostering acceptance and self-appreciation.

  • Alleviation of physical discomfort: The physical symptoms associated with eating difficulties, such as dizziness, nausea, headaches, weakness, and lack of energy, can be addressed through therapy. As individuals develop healthier eating patterns, their overall physical well-being improves, and the unpleasant physical sensations diminish.

  • Enhanced quality of life: Ultimately, therapy for eating difficulties aims to restore overall well-being and improve one's quality of life. By addressing the multifaceted aspects of the difficulties, individuals can regain control over their lives, engage in fulfilling activities, and experience a sense of freedom and joy beyond the constraints of their eating disorder.


Therapy provides a transformative journey toward healing, self-discovery, and empowerment, offering individuals the opportunity to reclaim their lives and thrive in a healthier and more fulfilling way.

How Long does the Treatment for Eating Difficulties Last?

According to the guidelines set forth by the National Institute for Health and Care Excellence (NICE), the recommended number of therapy sessions for eating disorders varies based on the specific diagnosis:

  • For binge eating disorder, up to 16 individual Cognitive Behavioral Therapy for Eating Disorders (CBT-E) sessions are recommended.

  • For bulimia nervosa, up to 20 CBT-E sessions are recommended.

  • For anorexia nervosa, a more intensive treatment approach is advised, with up to 40 CBT-E sessions recommended.

It's important to note that the total number of therapy sessions required for significant change can vary from person to person. Several factors come into play, including the complexity and severity of the eating difficulty, the individual's unique circumstances, and their readiness and willingness to engage in the therapeutic process.


The duration of therapy and the number of sessions needed will be determined collaboratively between the individual and their therapist, taking into consideration the specific needs and goals of the individual. Flexibility is crucial in tailoring the treatment to meet the individual's requirements, and adjustments to the treatment plan may be made as progress is assessed throughout the therapeutic journey.

Eating Difficulties Treatment in Herts/St Albans & Online

If you are seeking therapy for eating difficulties, whether in St Albans/Hertfordshire or through online sessions, I am here to support you in acquiring the necessary strategies to regain control over your eating habits. Through eating disorder therapy, you will be empowered to make vital changes that will restore balance and fulfillment in your life. Together, we can work towards overcoming the challenges posed by your eating difficulties and create a healthier relationship with food and your body.

Helpful Eating Disorders Resources:

If you would like therapy for eating difficulties in St Albans/Hertfordshire or online please email me at or complete the webform below.


St Albans Rooms

21 Victoria Street

St Albans



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