We are often asked about the underlying causes of eating disorders and whether those need to be addressed first for treatment to be successful.
When a person is malnourished, the effects extend far beyond physical health. Inadequate nutrition can significantly affect brain functioning, making it more difficult to think flexibly, regulate emotions, concentrate, and make decisions. Malnutrition can also intensify anxiety, obsessive thinking, rigid beliefs about food and weight, and distress around body image.
These effects can make it particularly challenging for adults and adolescents to engage fully in the psychological work necessary for lasting recovery. While concerns related to body image, self-worth, anxiety, and other factors that maintain the eating disorder are important treatment targets, they can be difficult to address effectively while the brain and body remain undernourished. In some cases, symptoms that appear to be underlying psychological difficulties may actually be caused or exacerbated by malnutrition itself.
For this reason, restoring adequate nutrition and supporting weight restoration are often central priorities in the early stages of treatment for restrictive eating disorders. This doesn't mean psychological treatment must wait until weight restoration is complete. Rather, our approach addresses both simultaneously, with an initial emphasis on nutritional rehabilitation.
In FBT, while parents take the lead in helping their child meet nutritional needs, individual therapy helps adolescents develop the skills to manage the anxiety, distress, and eating disorder thoughts that often accompany this process. As nutritional and medical stability improve, treatment can increasingly focus on addressing the broader psychological factors that contribute to the eating disorder and supporting lasting recovery.
Interested in learning more?
Schedule a free consultation with Union Square Cognitive Therapy to discuss your concerns and whether our approach may be a good fit.
Credit: Emma Hart, LMSW
