EMDR for Eating Disorders: How It Can Support Recovery
EMDR therapy can be a powerful approach to treating eating disorders because it addresses the underlying emotions, past experiences, and patterns of behavior that maintain eating disorder symptoms and make long-term recovery feel challenging. The premise of EMDR is that past experiences can influence present day behaviors and emotional responses. During memory reprocessing clients connect past situations with current emotions and physical sensations while engaging in bilateral stimulation, which can help change how distressing information is stored and accessed in the brain. As memories become less emotionally charged, they may no longer trigger the same visceral emotional responses and behaviors that once felt deeply engrained start to shift as negative beliefs about the self become more adaptive. Eating disorder behaviors that once reinforced beliefs around, for example, worthlessness or powerlessness may begin to feel less necessary and much less helpful than they did before. With many of my clients, EMDR not only helps them understand the function of their eating disorder, but it also helps them find different ways to meet their needs in more adaptive ways, whether that be through connecting with others, finding a deeper sense of self-worth, or establishing safer and healthier routines in their lives.
What is EMDR Therapy?
EMDR stands for Eye Movement Desensitization and Reprocessing therapy, and it was originally developed to treat trauma and PTSD. While it is still widely used for trauma-related concerns, research has shown that it is also effective for other issues as well, including eating disorders, addiction, mood disorders, attachment issues, anger, and relational dysfunction. As an EMDR therapist, I assess every client through an EMDR-informed lens, looking for past experiences that may be influencing their current emotional responses, behaviors, and ways of thinking. With some clients, this leads to memory reprocessing, where they focus on aspects of these past experiences while engaging in bilateral stimulation. For others, EMDR’s framework may be used to gain insight into current difficulties or to incorporate parts work to better understand their experiences and patterns.
Can EMDR Help with Eating Disorders?
EMDR can help with eating disorders by helping clients understand the experiences, beliefs, and emotional needs that may be contributing to their eating disorder behaviors. Past experiences that have led clients to develop negative ideas about themselves often fuel eating disorder behaviors and thought patterns. For example, someone with a history of feeling powerless may turn to food and exercise to exert a (false) sense of control over their lives, while someone who has learned to associate their self-worth with their appearance may strive to change how their body looks and feels in an attempt to feel more worthy. By exploring and reprocessing the experiences that contributed to these beliefs, clients can begin to understand the function of their eating disorder and how to meet these needs in more adaptive ways. Over time, they can learn to make choices that are more aligned with recovery rather than relying on eating disorder behaviors to cope.
How I Use EMDR in Eating Disorder Treatment
EMDR can be integrated into eating disorder treatment in several ways, depending on a client's history, symptoms, and treatment goals. Below are some of the ways I use EMDR to help clients identify and reprocess the experiences and beliefs that may be maintaining their eating disorder.
Reprocessing Experiences From When the Eating Disorder Began
Eating disorders often serve a function, sometimes developing as a survival skill or coping strategy that was necessary at one point but is no longer adaptive. By exploring what was going on in a client’s life when the eating disorder started, we often are able to identify what need it was meeting then and what negative belief it helped reinforce. When we reprocess memories around this issue, clients have reported a decrease in eating disorder urges and a healthier sense of self.
For example, imagine a client who experienced a significant loss during childhood and developed a strong sense of powerlessness. In an effort to feel more in control, this client turned to food and began restricting and overexercising because controlling what they put in their body felt better than processing the powerlessness and grief of losing a loved one. Here, the eating disorder served the purpose of avoiding pain and lack of control, but over time, it has become so all-consuming that it has impacted the client’s physical health and ability to form relationships. By reprocessing memories related to this loss, the client can begin to experience emotions they may not have been able to fully process at the time - such as powerlessness, grief, or anger - and may be less likely to rely on eating disorder behaviors when those emotions arise again.
Reprocessing Experiences That Reinforced Eating Disorder Beliefs
Another way I use EMDR in eating disorder treatment is to target memories of experiences that reinforced the eating disorder’s logic. This can include bullying, diet culture messaging from friends or family, comments about weight or appearance, sexual violence, or other experiences that reinforced negative beliefs about the self. These experiences can contribute to beliefs that thinness equates with worth, that being in a larger body is unsafe, that appearance determines whether someone is worthy of love or acceptance, or that they are unworthy or undeserving of having their needs met.
These experiences may not have been happening when the eating disorder first started, but they can strengthen the beliefs and emotional responses that keep eating disorder behaviors going over time. For example, someone may have started restricting for one reason, but years of comments about their body or messages about what makes someone attractive or worthy can reinforce the belief that changing their body is necessary to feel accepted. Reprocessing these experiences can help reduce the emotional intensity attached to these beliefs, making it easier for clients to challenge the eating disorder’s logic and move toward recovery.
Targeting Memories Within an Eating Disorder Memory Network
Another way I use EMDR in eating disorder treatment is by targeting memories within a memory network that is strongly connected to the eating disorder. For example, if a client has a strong negative belief that they are worthless, we may initially target memories from around the time their eating disorder began that reinforced this belief. From there, we may identify other experiences throughout their life that have contributed to the same belief, including memories from adulthood or even situations that are still happening in the present day. Because memories and beliefs are often interconnected, one experience may lead us to another memory that carries the same emotional response or negative belief.
Sometimes, reprocessing one or two memories is enough to create a noticeable shift in eating disorder thoughts or urges. For other clients, we need to work through several memories within the same network before they experience the change they are looking for. By targeting these connected experiences, EMDR can help clients recognize that the negative beliefs driving their eating disorder are not fixed truths, but beliefs that developed through their experiences and can change through reprocessing.
Addressing the Beliefs That Make the Eating Disorder Feel Appealing
I also use EMDR in eating disorder treatment by targeting experiences that reinforce the “positive” beliefs associated with the eating disorder. While eating disorder behaviors can be painful and disruptive, they can also feel like they are providing something important. For some clients, this may be the belief that their relationships depend on being thin, and that gaining weight would mean losing their ability to connect with the people they love. For others, it may be the belief that without their eating disorder behaviors, they would truly “lose control” of themselves, either physically or emotionally. In these situations, we may target memories that reinforce the belief that the eating disorder is the only way to feel connected, worthy, safe, or in control.
I often use this approach after we have already completed several reprocessing sessions targeting other memories. A client may understand logically and emotionally that their eating disorder is no longer serving them, yet still have moments when the behaviors feel appealing or necessary. When this happens, we can explore what the eating disorder is still offering them and identify the experiences that reinforced those beliefs. By reprocessing these memories, we can begin to loosen the positive connections to the eating disorder, not just the painful ones. In my experience, addressing both sides of that connection can be an important part of helping clients move toward lasting eating disorder recovery.
Using the Life-Stress Protocol to Address Present-Day Eating Disorder Urges
One final way I use EMDR in eating disorder treatment is through the Life-Stress Protocol, which allows us to start with a present-day eating disorder urge or situation rather than choosing a specific memory from the past. We may begin with a recent moment when a client experienced an eating disorder urge or engaged in an eating disorder behavior and explore what thoughts, emotions, physical sensations, and negative beliefs were coming up in that moment. Through bilateral stimulation, we can then “float back” to explore what past experience may be connected to the feelings that were coming up in the present.
I particularly like this approach for clients who have a lot of memories that may be contributing to their eating disorder symptoms. It can feel overwhelming to try to choose one memory to work on when there are so many experiences that could be connected to the eating disorder. Instead of trying to figure out where to start, we start with what is happening right now and allow the present-day experience to guide us toward the memories that may need to be reprocessed. This can help clients better understand the connection between past experiences and current eating disorder thoughts and urges while giving us a more focused place to begin the EMDR process.
Why EMDR Supports Lasting Change
One of the reasons I believe EMDR can support lasting change in eating disorder recovery is that we are not simply trying to change a thought or behavior in isolation. Eating disorder behaviors are often connected to a larger system of memories, beliefs, emotions, physical sensations, and patterns of responding that have developed over time. When we reprocess the experiences that are maintaining that system, clients can begin to respond differently when those same emotions or situations come up in the present. Instead of relying on an eating disorder behavior to feel safe, in control, worthy, or connected, they can begin to recognize that they have other ways of meeting those needs. This is what makes EMDR so powerful to me: we are not just asking someone to stop using an eating disorder behavior—we are helping change the underlying experiences and beliefs that made the behavior feel necessary in the first place.
Is EMDR Right for Everyone with an Eating Disorder?
EMDR can be a powerful tool in eating disorder treatment, but it is not necessarily the right approach for everyone at every point in their recovery. Eating disorders are complex, and treatment needs to be individualized based on a client’s symptoms, history, current level of stability, and treatment goals. For some clients, we may begin with stabilization and building skills to help them feel safer and more grounded before beginning memory reprocessing. For others, EMDR can be integrated into treatment earlier to address the experiences and beliefs that are contributing to their eating disorder symptoms. I also believe it is important to work with a therapist who understands eating disorders and can recognize when additional support, such as nutritional or medical care, is needed. The goal is not to use EMDR simply because it is available, but to determine whether it is a helpful and appropriate part of an individual’s overall eating disorder treatment.
If you're looking for an eating disorder therapist who incorporates EMDR into treatment, I provide virtual therapy for clients in Maryland, DC, South Carolina, Delaware and Florida. If you're wondering whether EMDR may be a good fit for your eating disorder recovery, reach out to schedule a consultation.
