In eating disorder treatment, do we focus on managing symptoms or addressing root causes?
There are so many issues tied into this question, at both a theoretical and very practical level. Treatment focused on symptom management often rests on the premise that the issues encountered in eating disorder recovery are the result, not the cause, of food restriction. From this perspective, when a person is nutritionally rehabilitated and weight-restored, many co-occurring symptoms like mood disturbances and body dysmorphia will naturally resolve.
In contrast, an approach that emphasizes addressing the underlying root causes sees disordered food behaviors as coping strategies for difficult and painful biopsychosocial events, past or present. From this perspective, sustainable recovery requires that we understand and address these deeper, more complex, dynamics.
In practice, symptom management often involves allocating food related decisions to healthy adults, parents, caregivers, or treatment centers, until the client demonstrates readiness for increased autonomy. An approach centered around exploring root causes may involve more input from the client, working gradually toward behavioral stability in ways that feel accessible and manageable to them.
How much and how deeply do we enter a client’s internal, subjective experience?
What one school of thought sees as essential to recovery, another might view as a distraction. What one sees as respect for a client’s right to self-determination, another might view as colluding with the eating disorder.
Like most things in recovery, these questions require non-binary thinking.
In this episode, Kirsten Hunneyball shares how these issues showed up both in her own recovery and in her work with clients. She reflects on the aspects of behavior modification that were necessary and even life-giving, as well as the places where those approaches fell short. Together, we discuss managing risk and safety while also moving beyond mere survival toward holistic health and well-being. We explore somatic treatment, the reality that eating disorders can be subtle and manipulative, and the importance of knowing when to challenge a client versus when to approach with gentleness.
Kirsten Hunneyball is a trauma-informed recovery coach, yoga teacher, and wellness facilitator based in South Africa. Having lived experience with an eating disorder, she supports individuals and small groups through meaningful personal evolution, particularly but not limited to the space of disordered eating. Kirsten integrates intuitive coaching, embodiment practices, and creative expression to help people reconnect with themselves, move through transition, and lead purpose-driven lives. She also has a podcast called “Curious About Recovery - Diving into Eating Disorders” Which is available on Spotify. You can find her website at
More on Kirsten: www.kirstenhunneyball.co.za
Kirsten's podcast, Curious about Recovery: https://open.spotify.com/show/1TwaZ2ID4FRQthckqfjR0h?si=gbHRZstJTByPEARZ41svTg
Connect with Elka https://elkacubacub.com/
Elka’s book, Binge Eating Demystified https://www.amazon.com/dp/B0FD493WZ3
