To the Contrary, it is About the Food Too

When I first started treating people with eating disorders, the novel and profound aphorism about treatment was simple: “it’s not about the food.”

Over time the effects of this saying grew into many powerful and effective facets of treatment. People with eating disorders felt more understood, and the opportunities for treatment with clinicians willing to listen and try to understand their experience grew exponentially.

Now, the tides have turned. To a large extent, eating disorder treatment has forgotten that recovery has to be about the food too.

I don’t mean to imply that dietitians aren’t doing their job or that treatment programs and teams ignore meal plans, recovery records or physical health progress. Just checking off the boxes for eating, weight and lab tests doesn’t qualify for the needed attention on food thoughts and behaviors.

One description of what is needed is called “food therapy.” This term coined by many dietitians over years reflects the need to combine therapeutic interventions with going over food logs at the same time.

Connecting emotions, thoughts and experiences with food day by day enables people in recovery to become acutely aware of how their eating disorder functions.

After even a few weeks of going over food logs, a person in recovery will be able to predict how certain behaviors early in the day or even the night before will translate into eating disorder behaviors. This ability will make it possible to foresee difficult periods and find ways to circumvent these behaviors either through actions, grounding techniques or working through feelings.

Only with food therapy will people in recovery be able to understand ways the eating disorder works in their lives. They’ll be able to sort through new ways to cope with difficult situations or emotions, navigate relationships and feel more able to engage with the world. Adding other modalities of therapy, referred to many times in this blog, makes full recovery possible.

The expansion of treatment and access to care that has made recovery possible for so many people with eating disorders has been transformative. The focus on food and meals needs to remain relevant and central to treatment to give people the best chance to get well.