Dialectical Behavior Therapy (DBT)

DBT blends behavioral strategies with mindfulness practices to create balance between acceptance and change. It teaches that two opposing things can be true at once—you can accept yourself as you are and still work toward change. This balanced mindset helps reduce self-criticism and guilt, which often fuel eating disorder behaviors and body dissatisfaction.

DBT is typically offered through individual therapy, group skills training, and coaching between sessions. The structure allows individuals to learn, practice, and apply skills in real-life situations. The treatment focuses on four main skill areas that address the emotional and behavioral challenges linked to eating disorders:

Mindfulness

Mindfulness helps individuals stay present in the moment and observe their thoughts, emotions, and physical sensations without judgment. For someone with an eating disorder, mindfulness can help identify hunger and fullness cues, recognize emotional triggers, and respond thoughtfully rather than react impulsively. It encourages awareness of the connection between the body and mind, helping patients view their experiences with curiosity rather than criticism.

Distress tolerance

Distress tolerance means learning how to handle difficult emotions or stressful situations without making them worse. Many people with eating disorders turn to behaviors like restriction, bingeing, or purging as a way to escape discomfort. DBT teaches alternative strategies—such as grounding techniques, distraction, and self-soothing—to help individuals manage emotional pain safely. Instead of trying to avoid or suppress distress, patients learn how to ride it out until it passes, strengthening their ability to stay in control even during challenging moments.

Emotional regulation

Emotional regulation is the ability to understand and manage emotions in a healthy way. People with eating disorders often feel overwhelmed by intense feelings such as shame, fear, or sadness. DBT helps them identify what they’re feeling, why they’re feeling it, and how to calm themselves without reacting impulsively or resorting to harmful behaviors. Over time, patients become more emotionally steady and confident in their ability to respond rather than react—building resilience and reducing the emotional triggers that lead to disordered eating.

Interpersonal effectiveness

Relationships often become strained for those struggling with eating disorders due to withdrawal, conflict, or difficulty communicating needs. DBT teaches assertiveness, setting boundaries, and communication strategies that strengthen relationships while preserving self-respect. Patients learn to express themselves clearly and compassionately, say no without guilt, and connect with others in authentic and supportive ways.

DBT addresses the emotional roots of eating disorders rather than just the behaviors. It helps individuals recognize that disordered eating patterns are often ways to manage emotional distress or regain a sense of control. By replacing these patterns with healthy coping skills, DBT breaks the cycle of emotional pain and self-destructive behavior.

For body image concerns, DBT promotes self-awareness and self-acceptance. Through mindfulness and radical acceptance, individuals learn to notice thoughts about their bodies without judging or reacting to them. This helps reduce body preoccupation and self-criticism while encouraging a more compassionate and balanced view of oneself. Over time, patients begin to focus less on appearance and more on overall well-being and self-worth.

DBT sessions are structured, collaborative, and skills-based. In individual therapy, patients identify personal goals, track triggers, and apply DBT tools to daily life. Group sessions reinforce these skills through shared learning and support. Between sessions, patients may complete practice exercises or keep logs to monitor progress and strengthen accountability.

Success in DBT is measured by more than just the reduction of disordered eating—it’s seen in improved mood stability, stronger relationships, and greater confidence in handling life’s challenges. Patients often describe feeling calmer, more balanced, and better able to make choices that align with their values and long-term goals.

DBT helps individuals develop lifelong skills that support ongoing recovery. Studies show that DBT reduces bingeing, purging, and restrictive behaviors while improving emotional control and overall well-being. Its emphasis on self-awareness and coping strategies helps prevent relapse and encourages continued growth.

Ultimately, DBT helps individuals move beyond the limitations of their eating disorder and body image struggles to create a life that feels purposeful, connected, and fulfilling. It’s not just about changing behaviors—it’s about rebuilding trust in oneself, developing compassion, and creating a sense of peace that supports long-term healing.