I work with adolescents and adults who are struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, chronic or yo-yo dieting, body dissatisfaction and/or low self-esteem.
Please note: I do not accept referrals for individuals with a BMI under 16.5 due to the health related implications of being at this low weight, which would benefit from the combined care of a multidisciplinary team.
The leading evidence-based treatment for eating disorders is Cognitive Behavioural Therapy - Enhanced (CBT-E; Nice Guidelines, 2017). There is a large body of research to suggest that CBT-E is effective in helping individuals suffering from eating difficulties to achieve full recovery. Due to this, CBT-E is the primary form of therapy used within treatment. However, at times, other therapeutic approaches might also be incorporated into the sessions, based on individual needs (detailed below).
Cognitive Behavioural Therapy for Eating Disorders
Cognitive Behavioural Therapy-Enhanced (CBT-E) is a specialised type of CBT tailored for eating disorders. It is based upon the premise that an individual’s thoughts, behaviours, and feelings are all connected and influence one another. Eating disorders are typically characterised by body dissatisfaction and self-critical thoughts. This often results in unhealthy behaviours around food (including limiting the amount or type of certain foods, overeating, bingeing and/or purging). In turn, this influences an individual’s emotions, and can lead to feelings of anxiety, worthlessness and/or low mood. The aim of CBT-E is to identify and address any unhelpful thought patterns/beliefs and behaviours around food and body image, in order to increase feelings of content, self-worth, and happiness.
Intuitive Eating is based on the premise that diets do not work in the long term (research has found that approximately 95% of all people who go on a diet regain the weight within 3-5 years, and approximately two thirds regain more weight than they lost in the first place). Intuitive eating is a way to replace diet mentality by tuning into and respecting hunger and fullness signals. The aim is to provide the body with sufficient energy without feeling uncomfortable from overeating or under-eating. Intuitive eating also encourages exercise for pleasure and health rather than for weight loss, and acceptance and compassion for bodies at their current size.
Acceptance & Commitment Therapy
Acceptance and Commitment Therapy (ACT) originated from Cognitive Behavioural Therapy and incorporated principles of mindfulness and acceptance. The premise of ACT is to accept the things in life that are out of our control (such as experiencing difficult feelings, thoughts or life circumstances) and committing to working towards a life that is meaningful and fulfilling through positive action. Mindfulness and acceptance based techniques are taught to aid acceptance of life circumstances that cannot be changed but may be causing distress. Mindfulness is the practice of focusing on the present moment and there is an increasing evidence base which shows that it can lead to improved happiness and contentment. The commitment element of the therapy involves identifying important values for the individual and exploring how they can live a life in line with those values.
Dialectical Behaviour Therapy
Dialectical Behaviour Therapy (DBT) is a form of Cognitive Behavioural Therapy that was developed for individuals who struggle with intense emotions. Such individuals might binge eat or purge as a means to soothe emotions or might engage in other behaviours such as self-harm. The aim of DBT is to help those individuals learn to manage difficult emotions by being able to experience, recognise and accept them. The therapy works using a balance of acceptance and change techniques. The primary elements of DBT focus upon regulating emotions, tolerating distress, dealing with difficult relationship dynamics, and learning mindfulness (being present in the current moment).