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Eating Disorder Professional Treatment - Group Therapy and Peer Support

Bridget Engel, Psy.D., edited by Kathryn Patricelli, MA

Group Psychotherapy

As a part of a treatment program, or in combination with outpatient individual therapy, group therapy may be recommended. Group therapy is an excellent source of treatment and support for those with bulimia or binge-eating disorder. It has not been as successful for helping those with anorexia. It is believed that this is because of the highly competitive attitude and distrust of others that those with anorexia typically show. When in a group format, those with anorexia tend to compare themselves to other group members and compete to be the thinnest.

There are a great deal of benefits from group therapy, including:

  • receiving education about the disorder
  • normalizing (group members learn that they are not alone in their condition)
  • supporting and acceptancing others (group members learn compassion and empathy for themselves and others)
  • gaining interpersonal skills and friendships
  • confrontating unhealthy behaviors.

Groups may be homogeneous. This means that all members have the same eating disorder. They may also be heterogeneous where members have an eating disorder, but of various types. A heterogeneous group typically includes those with anorexia and bulimia as they are more alike than those with binge-eating disorder. Those with anorexia and bulimia share similar causes for their disordered behaviors. Also, those with anorexia do better in mixed groups because they feel less threatened when comparing themselves to the more average-weight status of those with bulimia.

Peer Support Groups

Another group that may be ideal for those with binge-eating disorder is a support group called Overeaters Anonymous (OA). This group is based on an addiction model of treatment and is similar to Alcoholics Anonymous. Members learn to follow the Twelve Steps, and food is viewed as a drug over which those with eating disorders are powerless. The use of an addiction model for treating eating disorders is controversial in the medical community. The American Psychiatric Association does not recommend this type of program as the only treatment approach for anorexia nervosa or bulimia nervosa. They recommend it only in combination with other treatments. Those who are against this addiction approach suggest that there is little scientific proof that people can become addicted to certain foods. They also disagree that promoting the idea that those with anorexia or bulimia can never be fully recovered makes the faulty thinking worse. They also argue that there are too many variations in the quality of services from one support group to another. Because of these important criticisms, participation in OA should be viewed as a type of support group rather than as an official treatment. It should be done on an as-benefits basis. If such a program proves helpful, it should be continued, and if it seems to make things worse then participation should be stopped.

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