Eating Disorders Washington DC | Eating Disorders Therapist Dupont Circle

I know you’ve heard it before but breakfast truly is a very important meal. Many people avoid breakfast because they are afraid that they will eat more than they want to later in the day. By “saving up” on food or calories you are creating more opportunities for problematic eating as your day progresses. If you’re trying to get over food issues breakfast is even more important. How is breakfast an opportunity to heal?

  1. You’re symbolically starting your day off right. If you are carrying guilt from what you ate yesterday or already feeling fearful about what you will or won’t eat, breakfast provides you with the opportunity to work through those feelings.
  1. Once breakfast becomes a part of your routine it is a way to ground yourself when you are feeling out of control. Knowing that you will always have a routine around breakfast no matter what happened the day before and no matter what comes ahead. At the end of a difficult day you can know that you will start your day off with a clean slate.
  1. Eating breakfast is important for your mood. If you’re struggling with eating too much or too little or just thinking about food all the time, eating is important to get your emotional health back on track. Not having healthy blood sugar levels can make you feel worse. Feeling worse can then lead to more unhealthy behaviors.

LACK OF VARIETY = FOOD ISSUES | Psychologist, Eating Disorders, Washington DC

Washington DC Eating Disorders Therapist | Dr. Marie Land LLC | Dupont Circle

I first want to say as a disclaimer, some behaviors like the ones I’m about to mention are not a “problem” for people. A person who has a healthy relationship with food and her/his body can go a few days and eat the same exact thing and it not have any real negative consequences. For those people, food does not have meaning the way it can for those with food issues. Food is not related to emotions like guilt or joy for example. As someone progresses along the continuum of unhealthy eating behaviors or food their list of “good” foods becomes shorter and their list of “bad” foods becomes longer. This is of course an internal list that a person may not even know they have. It manifests when looking for food in a grocery store or picking out something from a menu at a new restaurant. A voice is there that quietly helps make the distinction between good and bad.

This type of experience starts early in life for many and for some it’s not an issue. For others the result is that anxiety increases when introduced to the possibility of eating foods that don’t feel safe to eat. What if they feel guilty after eating it? What if they eat more than they thought they would because it tastes so good? This nervous energy around eating coupled with anticipated guilt slowly makes it’s way into a person’s life until many foods become feared.

That is why VARIETY is an extremely important factor in healing eating issues. If you are afraid of eating things because you’re afraid they will make you gain weight or over eat, then you are going to eventually get to a crossroad. You’re going to have to try to eat outside the short list of approved food items.

People have foods they consider SAFE and they often eat them over and over again. Unfortunately when you spend most of your time eating safe foods the result is more and more foods become dangerous. You will not become safe by avoiding everything that you view as scary.

By slowly exposing yourself to new foods your anxiety for each of them decreases. Ultimately that’s what you want if your goal is to feel comfortable around food or to decrease both binging or restrictive behaviors. Increasing variety should be a slow process and foods that are giving you discomfort should be tried once and then not tried again for awhile. Eating 3 peanut butter sandwiches (one for each meal of the day) is not the way to expose yourself to new foods. However, integrating a couple foods that give you discomfort each week can be very helpful in your healing. Going for the most challenging food items (the ones that you want to avoid at all costs) first probably isn’t a good idea. Slowly working your way to integrate foods that create mild anxiety and discomfort at first is a better, more gentle approach to increasing variety.


Eating Disorder Therapist Washington DC | Dr. Marie Land LLC

In psychology the analogy of an iceberg is often useful and I can think of no instance more appropriate to use it than the in case of eating disorders. Family members (and even therapists are sometimes guilty) express a level of concern for someone with eating issues based on what they see or don’t see. If someone lost or gained 20 pounds in a month or stopped eating dinner for 2 weeks it would raise a red flag for most. The truth is that most people who are struggling with food or eating appear to be “normal” in their habits. It’s not surprising then that when someone comes out to family or friends that they are struggling with food they may not always get the level or empathy of compassion they deserve. So why is that? What you SEE does not necessarily correlate with the amount of suffering a person is experiencing. There are two things to consider when it comes to eating issues. First, BEHAVIORS (eating, not eating), which are the tip of the iceberg. Second, the AMOUNT OF MENTAL SPACE that is taken up in a person’s mind. The time that someone spends thinking about food, body image, eating, and not eating is strongly correlated with a person’s level of suffering. Unfortunately, you can’t always see suffering.

You may be talking with your best friend about what happened on your date last night and they can be completely engaged in the conversation. However, you would have no clue that the entire time they were speaking with you they had their attention on a constant stream of negative thoughts (or images) and fears related to eating and/or their bodies. That’s why I always try to get a sense of how much time someone spends thinking about things related to eating and their physical appearance. Someone may not be engaging in behaviors that would get them a diagnosis of an eating disorder but their brains, emotions, and suffering are congruent with a person who has a diagnosable eating disorder and they deserve the same attention and help.


Eating disorders have been steadily increasing in prevalence in the United States in recent decades. By now most adults have grown up with peers they suspected had eating disorders. The knowledge we have today about eating disorders (and the mixed messages from media and other poor sources) leaves some quick to judge, “my girlfriend (or kid, or boyfriend) doesn’t have an eating disorder...he/she eats!” and others are left confused about and unsure about what is normal and abnormal. Eating disorders do not fit nicely into the box that the DSM (diagnostic and statistical manual) or google searches provide. People are often situated along a continuum of symptoms with some visible to the eye and others completely unobservable. The average woman in the United States has spent some time on that continuum starting at a mild discomfort with her body or food all the way to being completely plagued by thoughts of food every 3 seconds. We have diagnostic criteria for a reason. Symptoms observable in behaviors are helpful because behaviors are:

1. Often an indicator that more complex distress exists

2. Help us conduct research to improve treatments

3. Help us all stay on the same page and provide “effective” treatment.

Still, we don’t have to get all diagnostic here. You don’t have to jump up and say, " you have an eating disorder!"First, that’s frequently not the best thing to say to someone. Second, it takes time and an experienced clinician to determine that. Third, there is a common goal here regardless: You (and most people) want your loved one to be able to go through life not struggling with food and body image. You may have a strong feeling about this because of stories you’ve heard from other friends, TLC and hallmark shows, or perhaps because even you have walked that line at some point where you wished that you could be a little less self-critical of your body, and think a little less frequently about your weight. If you've ever struggled with eating issues then chances are you certainly wouldn’t want your loved one to deal with such a feeling out of empathy.

Whether or not such seemingly "normal" things like wanting to lose weight or criticizing oneself for eating a candy bar is a "problem" to someone is perhaps something only that person can decide. And when that method fails (and it certainly does), then hopefully a well trained therapist can help bring some clarity.