# Eating disorders and body image > Body image concerns and eating disorders, and how clinical psychologist Jess Chadakorn works with people experiencing them, from assessment to CBT and ACT. Source: https://jess.ac/areas-of-support/eating-body-image/ Unease about food or your body can grow until it shapes everyday choices, such as what to eat or whether to accept a dinner invitation. Jess works with children, teenagers and adults experiencing body image concerns, disordered eating and eating disorders, often alongside medical and dietetic care. ## From body image concerns to eating disorders A person's relationship with food and their body sits on a spectrum. At one end, eating is relaxed and flexible. Further along is disordered eating, such as strict dieting or feeling out of control around food, which can be distressing without meeting criteria for an eating disorder. Eating disorders are serious illnesses affecting physical and mental health, and recovery is possible, including after many years. Anorexia nervosa and bulimia nervosa are the most widely known, and binge eating disorder is more common than either. In ARFID (avoidant/restrictive food intake disorder), eating is limited by factors such as sensory sensitivity or a fear of choking, and body image is usually not central. Many eating disorders fit none of these and are diagnosed as other specified feeding or eating disorder (OSFED). ## Who can be affected Eating disorders and body image concerns affect people of all genders, ages, cultures and body sizes. Men and people in larger bodies may find it harder to recognise what is happening or to ask for help. LGBTQIA+ people are affected at higher rates, which researchers link to the ongoing stress of stigma and discrimination. Eating difficulties are also more common among neurodivergent people. For some autistic people, sensory sensitivity or difficulty noticing hunger and fullness makes eating hard in ways unrelated to appearance. Some people with ADHD miss meals when busy or eat to settle restlessness. Jess has a particular interest in working with neurodivergent people and adapts sessions to sensory and attention needs. ## Working as part of a care team Jess provides psychological treatment, addressing the thoughts, feelings and patterns that maintain an eating disorder. A GP monitors physical health, which matters even when someone looks and feels well. Where helpful, a dietitian experienced in eating disorders can support a return to regular, flexible eating. ## What therapy with Jess involves Eating difficulties sometimes begin as a way of coping with something hard. Jess's assessment and formulation look at how yours began and what keeps them going, and understanding this can ease the shame that often comes with them. From there, you and Jess agree a treatment plan. Sessions might include loosening food rules with a dietitian's input, finding other ways to manage strong emotions, and spending less time checking or comparing your body. You and Jess agree the pace of change around food, break large steps into smaller ones and review the plan regularly. ## Things people often notice - Thinking about food or your body for much of the day - Food rules that feel hard to bend - Guilt or worry after eating - Comparing your body with others, including online - Avoiding photos or social plans because of how you feel about your body - Using food, or avoiding it, to cope with hard feelings ## Approaches Jess may draw on - **[Cognitive Behaviour Therapy (CBT)](https://jess.ac/approaches/cbt.md).** Enhanced CBT (CBT-E), one of the most studied treatments for eating disorders in adults, usually starts with regular eating, then addresses the rules and beliefs about food and body shape that keep difficulties going. During her Master's, Jess completed a placement with the Eating Disorders Clinical Hub (STRIDE program, ACT Health), where she used CBT for eating disorders, including the ten-session CBT-T. - **[Acceptance and Commitment Therapy (ACT)](https://jess.ac/approaches/act.md).** ACT helps you make room for painful thoughts about your body and put more energy into what matters to you. Research reviews suggest it can ease body dissatisfaction for some people. - **[DBT skills](https://jess.ac/approaches/dbt-skills.md).** DBT skills, adapted for binge eating and bulimia, are practical ways to notice strong emotions and tolerate them without turning to food. - **[Schema Therapy](https://jess.ac/approaches/schema-therapy.md).** Schema therapy explores long-standing patterns that often begin in childhood, such as feeling not good enough, and how eating or body concerns have grown around them. It has been studied for binge eating and bulimia. ## For children and teenagers Younger children may avoid more and more foods, while teenagers face pressure about their bodies from peers and social media. For many young people with anorexia nervosa, Australian and international guidelines recommend family-based treatment, where a clinician guides parents to support meals at home until the young person can manage them again. Jess sees children and teenagers and can discuss suitable support with families. ## Questions ### Do I need a diagnosis or referral to see Jess about eating or body image? No. You can start without a diagnosis or referral by booking directly, paying the clinic's fee and claiming from private health extras if your cover includes psychology. For a Medicare rebate, you need a referral from a GP, psychiatrist or paediatrician, either under Better Access or, if you are eligible, with an Eating Disorder Treatment and Management Plan, which also gives rebates for dietitian sessions. ### What if I'm not sure whether my eating is a problem? Eating concerns often develop gradually, and the thoughts that come with them can make their effect hard to judge. An assessment with Jess can clarify this. The Butterfly National Helpline (1800 33 4673) also offers phone support from 8am to midnight (AEST/AEDT), seven days a week. ### What happens if more support is needed than weekly sessions can offer? Some eating disorders need more intensive care, such as a day program or hospital-based treatment. Jess can discuss options with you, and your GP can help arrange them. If you are worried about your immediate safety or physical health, call 000 or go to your nearest emergency department. Lifeline is available any time on 13 11 14. ## Further reading - [Eating disorders](https://butterfly.org.au/eating-disorders/) (Butterfly Foundation) - [Eating disorders explained](https://nedc.com.au/eating-disorders/eating-disorders-explained/) (National Eating Disorders Collaboration) - [Eating disorders](https://www.healthdirect.gov.au/eating-disorders) (healthdirect)