Using ACT Skills for Eating Disorder Recovery
By Jennifer Rollin, MSW, LCSW-C, Therapist and Founder of The Eating Disorder Center
If you are in eating disorder recovery, you may already understand on an intellectual level that many eating disorder thoughts are distorted or extreme. And yet, in the moment, those thoughts can still feel overwhelming, convincing, and hard to ignore. Knowing something logically does not always make it easier to act differently when anxiety shows up.
In my work as a therapist treating eating disorders, I see two patterns come up again and again.
First, many people are deeply fused with eating disorder thoughts. These thoughts are not experienced as mental noise. They feel like facts, rules, or warnings that must be followed. Often, it does not even feel like a thought. It feels like the truth.
Second, while they are not choices-eating disorder behaviors often develop as subconscious coping strategies. Restriction, bingeing, purging, or compulsive exercise are not about vanity or lack of willpower. They are often attempts to manage overwhelming emotions, trauma responses, anxiety, shame, or a sense of being out of control. Eating disorders are serious mental illnesses that sometimes begin as ways to survive painful internal experiences.
Acceptance and Commitment Therapy, or ACT, is one approach we use as therapists at The Eating Disorder Center because it does not require you to get rid of thoughts or feelings in order to heal. Instead, ACT focuses on changing your relationship with your internal experience so you can move toward the life you want, even when discomfort shows up.
Thought Defusion in Eating Disorder Recovery
Cognitive defusion skills help you create distance from eating disorder thoughts, rather than automatically believing or obeying them. The goal is not to argue with the thought or prove it wrong. Instead, the goal is to notice the thought and decide whether following it moves you closer to recovery and the life you care about.
ACT does not ask you to determine whether a thought is true or false. It asks a different question. Is this thought helpful in moving me toward the kind of life I want to live?
Below are several cognitive defusion strategies that many people find helpful in eating disorder recovery.
1. “I Am Having the Thought That…”
One of the simplest defusion tools involves changing how you relate to your thoughts through language.
When you notice an eating disorder thought, try adding the phrase:
“I am having the thought that…”
For example:
“I am having the thought that I cannot eat carbohydrates.”
You can take this one step further:
“I am noticing that I am having the thought that I cannot eat carbohydrates.”
This small shift can be powerful. It helps you see thoughts as experiences happening in the mind, not rules you must follow. Over time, this can weaken rigid eating disorder rules and create space for choice.
2. Labeling Repetitive Eating Disorder Stories
Many eating disorder thoughts come in predictable, repetitive storylines. Giving these stories a name can reduce how seriously they are taken.
For example:
“This is the ‘If I recover, I will not be able to cope’ story.”
“This is the ‘I cannot trust my body’ story.”
Labeling these patterns helps you recognize them more quickly. Instead of being pulled into automatic behaviors, you can pause and choose a response that supports recovery.
3. Using Metaphor and Analogy
ACT often uses metaphors because they help bypass endless mental debates.
One analogy many people find helpful is imagining eating disorder thoughts as unhelpful TikTok videos. You can click on them, analyze them, and watch them all the way through. Or you can notice them and swipe past. With enough swiping, the algorithm begins to change.
Others prefer thinking of eating disorder thoughts as spam emails or scam texts. They may still show up, but you do not need to open them, respond, or engage.
These metaphors help normalize the presence of eating disorder thoughts in recovery while reducing the urgency to act on them.
4. Practicing Psychological Flexibility in Recovery
Psychological flexibility is the ability to stay present, open, and engaged with your life even when uncomfortable thoughts, emotions, or body sensations show up. Eating disorders thrive on rigidity. Rules around food, movement, and body image may feel protective, but they often make life smaller and cause people to feel more trapped over time.
In recovery, psychological flexibility might look like choosing a different meal than the eating disorder demands, tolerating uncertainty around hunger or fullness, or staying connected in a social situation even when anxiety is present. These choices are not about feeling confident or calm. They are about being willing to experience discomfort in service of a fuller, more meaningful life.
Each time you practice flexibility, you strengthen your ability to respond to life rather than react from fear. Over time, this flexibility becomes a core part of recovery.
5. Noticing How the Eating Disorder Pulls You Away From Your Values
One of the most powerful ACT ideas in eating disorder recovery is recognizing how the eating disorder pulls you away from what truly matters to you. Eating disorder thoughts often promise ‘safety,’ a (false) sense of control, or relief, but over time they tend to shrink your life and distance you from your values, such as connection, freedom, creativity, or presence with loved ones.
In ACT, we often use the passenger on the bus metaphor. You are the driver of the bus, and your values represent where you want the bus to go. Eating disorder thoughts are loud passengers. They may yell, criticize, threaten, or demand that you turn the bus around. In recovery, the goal is not to throw the passengers off the bus or make them quiet. The goal is to keep driving toward your values even while those passengers are present.
You can acknowledge the eating disorder voice without letting it steer. Each time you choose a recovery aligned action, even when fear is along for the ride, you strengthen your ability to live in accordance with your values rather than the eating disorder’s rules.
Bringing It All Together
In eating disorder recovery, ACT focuses on helping you:
- Notice and defuse from unhelpful thoughts
- Allow uncomfortable emotions without using eating disorder behaviors to escape them
- Clarify your values around recovery, relationships and meaning
- Take steps aligned with those values, even when fear or discomfort is present
Eating disorders are complex, serious mental illnesses, but they are also highly treatable. With the right support, skills, and specialized care, full recovery is possible.
At The Eating Disorder Center, founded by Jennifer Rollin, LCSW-C, we provide compassionate eating disorder treatment for individuals struggling with anorexia, bulimia, binge eating disorder, ARFID, OSFED, compulsive exercise, chronic dieting, disordered eating, and body image distress.Our team specializes in outpatient eating disorder treatment and uses approaches such as ACT, DBT, CBT, trauma informed care, and other recovery oriented modalities to support long term healing. Many of our providers are personally recovered.
We offer eating disorder therapy for clients in Rockville, Maryland serving Bethesda, Chevy Case, Gaithersburg, Potomac, Olney, Germantown, Maryland, and virtually throughout Maryland, Virginia, DC, Pennsylvania, Florida, and California, as well as eating disorder recovery coaching worldwide.
If you are in recovery and looking for specialized support, you do not have to navigate this alone.
Schedule a FREE 15-minute consultation to explore how eating disorder therapy or recovery coaching can help you to find freedom.
🌟 Available in MD, VA, DC, PA, FL, and CA for eating disorder therapy
🌍 Offering recovery coaching worldwide
