Food can carry far more than hunger.
Some people come to food therapy because eating feels like a battle.
Some aren’t sure if their relationship with food is a problem.
Others only come because someone who loves them is worried.
Maybe you feel:
- afraid
- ashamed
- out of control
- preoccupied
Food and eating patterns often start as ways to cope with something hard.
Food therapy can help you understand what food has been doing for you.
What is Food Therapy?
Food therapy helps you understand your relationship with food and with your body.
It starts from the idea that your relationship with food has a history and is shaped by how you feel.
Food therapy also looks at your experiences, including whether food was ever limited.
It can help with restricting, bingeing, purging, chronic dieting or a constant focus on food and weight.
Eating concerns affect people of every age, gender, culture and body size.
For teens, therapy often includes parents, since families can play a big part in recovery.
How Food Therapy Helps
Therapy gives you a place to talk about food without judgment.
It can help whether your eating concerns are new or have been with you for years.
In food therapy you can learn to:
- cope with feelings in new ways
- listen to your intuition and body
- notice hunger and fullness
- separate your worth from your body
- understand what eating does for you
Therapy can’t change a culture that judges bodies, but it can help you see your body apart from others’ opinions.
Recovery takes time, because changing how you eat can bring up feelings food used to cover.
Food can become something that nourishes you.
What is a Food Therapist?
A food therapist is a registered therapist who helps people with eating concerns and their relationship with their body.
Eating concerns often need specialized treatment, and many therapists seek extra training to work with them.
Many therapists work from a weight-inclusive approach, so therapy isn’t about weight loss.
Some train in family-based treatment, where parents help a teen recover at home, or in a cognitive behavioral therapy made for eating disorders.
Some work with doctors and dietitians, since eating concerns can affect physical health.
What matters most is that the therapist is a good fit for you, whatever approach they use.
Some Approaches for Food Therapy
Compassion-Focused
It helps soften the blame, shame and self-criticism that often come with eating concerns.
Dialectical Behavior
It builds skills for big feelings that can show up before, during and after eating.
Family Systems
It looks at how eating concerns affect the whole family, and how family can support recovery.
Somatic
It helps you reconnect your mind and body, listen to them and trust what they’re telling you.
What to Expect in Food Therapy
Food therapy often starts with making sure your body is safe, since eating concerns can affect your health.
You might talk about messages you heard about food, weight and bodies growing up, and what meals felt like.
Early sessions often explore when eating feels hardest, what helps and what makes it worse.
Your therapist might ask about your eating, how you feel in your body and whether things have changed over time.
Checking in with a doctor can also help, and you can contact the National Eating Disorder Information Centre at 1-866-633-4220.
If past treatment focused only on eating or weight, that’s worth sharing.
Food therapy can be short-term for specific concerns, or longer when eating is tied to trauma or long-held patterns.
Eating concerns were named long before they were understood.
In 1689, English physician Richard Morton described a young woman who was wasting away without any clear illness.
He called it nervous consumption, and traced it to her sadness and worries, which he called passions of the mind. He gave her the usual remedies for wasting, like bitter tonics and stomach medicines. She soon grew tired of them, and died a few months later.
For centuries, girls and women who stopped eating were often explained through religion, as holy or miraculous. In 1869, a 12-year-old Welsh girl named Sarah Jacob was said to live without food. Believers saw a miracle. Doctors saw a fraud, and sent nurses to watch her day and night. She died of starvation eight days later.
Four years later, two doctors described it as a medical illness. In London, Queen Victoria’s physician William Gull called it anorexia nervosa. In Paris, Charles Lasègue called it hysterical anorexia and noticed it was tied to tension in families. Self-starvation had moved from religion to medicine.
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In 1944, physiologist Ancel Keys asked 36 young men to eat much less for six months. They were conscientious objectors who volunteered instead of going to war. The men became obsessed with food, read cookbooks for hours and grew anxious and depressed. When food returned, many found it hard to stop eating. The study showed restriction itself can create many of the struggles once blamed on character.
In the 1940s and 1950s, Canadian government researchers ran nutrition experiments on Indigenous children in residential schools. Some hungry children were kept on poor diets on purpose, to serve as comparisons. Historian Ian Mosby brought the experiments to light in 2013.
In 1959, psychiatrist Albert Stunkard described people who ate large amounts of food in a short time and felt unable to stop.
By the 1970s, anorexia was often dismissed as vanity, a girl’s wish to look thin. In 1978, psychiatrist Hilde Bruch published The Golden Cage, named for a patient who felt like a sparrow trapped in a golden cage. Bruch argued anorexia was not about vanity, but about a struggle for control by young people who felt they had little say over their own lives.
In 1979, London psychiatrist Gerald Russell described 30 patients who binged and then made themselves vomit or used laxatives, often in secret. He called it bulimia nervosa, and saw it as an ominous form of anorexia.
In 1980, Oxford researchers Christopher Fairburn and Peter Cooper placed a notice in Cosmopolitan magazine asking women about binge eating and making themselves vomit. Over 600 women replied who were doing it in secret. Most had never told a doctor.
In 1983, singer Karen Carpenter died of heart failure linked to anorexia. After more than a century in medical books, many people heard the word for the first time, and anorexia became a household word.
In Fiji, larger bodies had long been seen as a sign of health and care. Then, in 1995, television arrived. Three years later, anthropologist Anne Becker found that signs of disordered eating among teen girls had more than doubled. Many now felt too big, and some had begun making themselves vomit to lose weight, which none had reported before.
Binge eating disorder is the most common eating disorder, but psychiatry’s diagnostic manual set it aside in an appendix in 1994 and didn’t recognize it as its own diagnosis until 2013.
But eating concerns are still often hidden, missed or dismissed.
Many people picture eating concerns in young, white, thin women, so men, people of color, people in larger bodies and older adults are often missed.
Treatment often focuses on weight and food, and less on what eating helps people cope with.
People with eating concerns have often lived through trauma, but they aren’t always asked about it.
And growing up without enough food can shape eating for years, but food insecurity is rarely part of treatment.
Trauma-sensitive food therapy works inside those gaps. It asks what food has helped you survive, and what it was like if you had to go without. It works with, not against, your body. It recognizes eating concerns in every body. And it moves at a pace that feels safe, so you don’t lose a way of coping before you have another.
Trauma-sensitive therapy starts with curiosity.
Trauma-Sensitive Food Therapy
What if food helped you survive?
When feelings or experiences were too much, food may have been one of the few things you could control.
Trauma-sensitive therapists understand that eating concerns can be a response to what happened to you.
5 phrases you might hear in Trauma-Sensitive Food Therapy:
- What was happening before that urge?
- It makes sense you found a way to cope.
- What is your body telling you?
- We can go at your pace.
- What did food mean in your family?
Trauma-sensitive food therapy invites you to trust your body.
Principles of Trauma-Sensitive Food Therapy
Coping is caring
Restricting, bingeing or purging may have helped you get through hard times. Understanding what they do for you can help.
One step at a time
Letting go of a way of coping can feel risky. Building new ways to cope comes before changing how you eat.
Not good or bad
Food doesn’t have to be labeled good or bad, clean or junk. Letting go of labels can ease the guilt or shame that often come with food.
Food is more than fuel
Food carries culture, family, comfort and connection. All of it belongs in the work, not only what and how much you eat.
Questions You Can Ask a Food Therapist
A consultation is a good time to ask questions. Trust how you feel after the conversation as much as the answers themselves.
How do you understand eating concerns?
Do you work with people in all body sizes?
Will we talk about what’s underneath?
Do you work with a doctor or dietitian?
What if I’m not ready to change how I eat?
How do you involve family?
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