What we are talking about
This includes anorexia nervosa, bulimia nervosa, binge-eating disorder, episodes of loss of control over eating, and other eating-related difficulties that cause significant distress without meeting full diagnostic criteria.
These are demanding clinical situations that often benefit from multidisciplinary care — psychological, medical and nutritional.
How it can show up
- · Marked food restriction or rigid eating rules.
- · Eating episodes with a sense of loss of control.
- · Compensatory behaviours after eating.
- · Persistent preoccupation with weight and body shape.
- · Shame, secrecy and isolation around eating.
- · Mood fluctuations linked to eating and weight.
When it may make sense to seek support
When eating takes a central place in daily thinking, when there is distress, repeated loss-of-control episodes or compensatory behaviours, or when there are signs of physical repercussions. In such cases parallel medical assessment is important.
How assessment is carried out
Through a detailed clinical interview on eating history, current patterns, maintaining factors, body image, and emotional and relational functioning. Validated instruments may be used. Coordination with a physician and dietitian is considered.
What intervention may involve
- · Progressive stabilisation of eating patterns, alongside nutritional care when indicated.
- · Work on rigid eating rules and dichotomous thinking.
- · Intervention on body image and self-criticism.
- · Development of alternative emotion-regulation strategies.
- · Understanding the role of relational and family context.
- · Relapse prevention.
What to expect from a first session
The first session is mainly about understanding the current situation: what brought you here, for how long, and how it is interfering with daily life. It is also a space to gather relevant history and context, clarify needs and expectations, and make an initial assessment of whether psychotherapy is a suitable response.
Next steps are defined together at the end. If psychotherapy is not the most appropriate answer, that is said clearly and alternatives are suggested.