Eating Disorders, Body Image and Emotional Regulation: A Guide for Counsellors
Written by the ICPS College Academic Team · Reviewed by ICPS College faculty · Last reviewed: September 2026
Eating disorders are serious mental health difficulties that affect people of every age, gender, background and body size. They are not lifestyle choices or phases, and they are rarely only about food. For counsellors and psychotherapists, understanding the role of body image and emotional regulation is central to working safely and compassionately.
Understanding eating disorders
Recognised presentations include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID) and other specified feeding or eating disorders. Presentations often overlap or change over time. Because eating disorders carry significant physical as well as psychological risk, they call for coordinated care involving a GP and, where needed, specialist services.
Body image
Body image describes how a person perceives, thinks and feels about their body. Difficulties can include preoccupation, avoidance, checking and a sense that self-worth depends on appearance. Therapeutic work tends to focus less on changing how a body looks and more on changing a person's relationship with it: reducing self-criticism, broadening sources of self-worth and developing a more respectful, functional view of the body.
Eating difficulties and emotional regulation
Many clients describe eating behaviours as ways of managing feelings that seem unbearable or hard to name. Counselling can help clients build a wider range of ways to notice, tolerate and express emotion. Useful areas of work include:
Developing emotional awareness and a vocabulary for feelings.
Building distress-tolerance and self-soothing skills that do not involve food.
Exploring self-criticism and developing self-compassion.
Understanding the client's own sense of what their eating difficulties do for them, in their words and at their pace.
Strengthening relationships and support outside therapy.
The counsellor's role and limits
Counsellors play an important part in recovery-oriented care, but they should not work in isolation. Good practice includes:
Working collaboratively with the client's GP, who can monitor physical health.
Knowing when a referral to specialist eating disorder services is needed.
Avoiding comments on weight, shape or food choices, and not offering diet or nutrition advice outside one's competence.
Attending to risk, including self-harm and suicidality, which can accompany eating disorders.
Using supervision to reflect on one's own attitudes to food, weight and bodies.
Language and stigma
Person-first, non-judgemental language matters. Clients often carry considerable shame, and a counsellor's words can either reinforce or ease it. In Ireland, Bodywhys, the Eating Disorders Association of Ireland, provides support and information for people affected and their families. Anyone in immediate danger should contact 112 or 999.
Further training
The Professional Diploma in Eating Disorders, Body Image & Emotional Regulation is a live-online programme carrying 60 CPD credits. It covers eating disorder presentations, body image, emotional regulation, multidisciplinary working and ethical, risk-aware practice for counsellors, psychotherapists and allied professionals.
Related ICPS College courses
References
National Institute for Health and Care Excellence (2017) Eating disorders: recognition and treatment (NICE guideline NG69). London: NICE.
Important information
This article is educational content for practitioners and learners. It is not a substitute for professional advice, counselling or therapy.
If you are struggling or in distress in Ireland, you can call Samaritans free on 116 123 or text HELLO to 50808 at any time. In an emergency, call 112 or 999.
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