Body image
Body image difficulties and eating disorders are complex and serious experiences that can have a significant impact on emotional wellbeing, physical health, relationships, and daily life.
These difficulties do not discriminate based on gender, age, ethnicity, or background. Many people experiencing them appear highly functioning externally while privately struggling with shame, anxiety, guilt, self-criticism, and an exhausting relationship with food, exercise, or their body.
Often, these patterns are not really just about food or appearance. Underneath, there can be deeper struggles with self-worth, emotional regulation, perfectionism, control, overwhelm, or feeling not good enough.
When body image starts taking over
The deeply held belief of being fundamentally defective or “not good enough” can shape the way you see yourself, your relationships, and the world around you.
For some people, it begins with body dissatisfaction or wanting more control around food, exercise, or weight. Over time, these behaviours can become increasingly rigid, distressing, and difficult to stop.
You might notice:
constant thoughts about food, weight, or body shape
restrictive dieting
rigid “good” and “bad” food rules
black-and-white thinking
over-exercising
binge eating
secrecy around food
avoiding meals with other people
guilt or shame after eating
feeling emotionally overwhelmed by eating or body-related thoughts
Often, people feel trapped in cycles that they know are not helping, but also feel frightened to let go of.
Many people I work with are very disciplined, perfectionistic, and hard on themselves. The eating disorder behaviours can begin to feel like a way of coping, managing emotions, reducing anxiety, or creating a sense of control, even when they are also causing distress.
Bulimia Nervosa
Bulimia nervosa is characterised by recurrent binge eating episodes, where someone consumes a large amount of food while feeling out of control, followed by compensatory behaviours such as vomiting, fasting, excessive exercise, or laxative misuse.
These patterns are often driven by an over-evaluation of body shape or weight in determining self-worth.
Bulimia can lead to:
intense shame
secrecy
emotional distress
weight fluctuations
dental erosion
gastrointestinal issues
electrolyte imbalances
ongoing physical exhaustion
People often feel caught in a painful cycle of bingeing, guilt, and attempts to regain control.
Binge Eating Disorder
Binge Eating Disorder also involves recurrent binge eating episodes, but without compensatory behaviours afterwards.
People may eat very quickly, eat in secret, continue eating when uncomfortably full, or feel unable to stop once the binge has started. Afterwards, there is often significant shame, self-disgust, hopelessness, or emotional distress.
Mixed or overlapping symptoms
More commonly, people present with a combination of eating disorder symptoms and behaviours that may not fit neatly into one category.
Even when someone does not meet full diagnostic criteria for a particular eating disorder, the symptoms can still be debilitating and deserve support and treatment.
How therapy can help
I have a particular interest in working with people experiencing body image difficulties, bulimia nervosa, binge eating disorder, and related eating disorder symptoms.
Part of the work is understanding not just the behaviours themselves, but what may be sitting underneath them emotionally and psychologically.
Therapy can help you begin to understand:
the role these behaviours are playing
the beliefs driving them
the perfectionism, guilt, or self-criticism underneath
the emotional triggers connected to food or body image
the relationship between eating patterns, emotions, stress, and self-worth
Over time, the goal is not simply to “control” eating differently, but to develop a less punishing and more manageable relationship with yourself, your emotions, your body, and food.