Katie Yacu

Psychology and Eating Disorders

When thinking about eating disorders and obesity, it can oftentimes seem like a simple solution to say: “Why doesn’t the person just change their eating habits?” However, psychology shows that there is a lot of complex factors that play into a person’s willingness or unwillingness to eat. By considering one’s mental state when performing a specific behavior, in this case, eating; physicians, therapists, and nutritionists can develop effective, long-lasting treatment.

What is Self-Psychology?

Self-psychology, developed by Heinz Kohut, takes into account an individual’s personal experience, which plays a strong role in the development of eating disorders (Di Luzio, 2015). In self-psychology, the “self” is basically the center of one’s psychological mindset. If a child’s developmental upbringing is appropriate, a healthy sense of self will typically develop. This will allow the individual, in adulthood, to be able to maintain consistent patterns and regulate themself throughout life (Bryant-Waugh et al.,  2010). This includes developing positive self-esteem and body image (Brechan, 2015). When individuals are not able to develop a healthy sense of self because of rocky events, especially as a child, they may tend to rely on other things in order to get needs met (Bryant-Waugh et al., 2010). In this case, a person is not able to regulate themself very well and lacks the ability to self-comfort and self-soothe. Other coping strategies a person may seek are called self-object needs (Di Luzio, 2015). Self-object needs are needs that are found outside the self, like comfort from human interaction and positive reinforcement. As humans, there is a habit to seek mirroring self-object needs. Mirroring self-object needs is the idea that people seek positive responses from other people as a mirror to see positive traits within themselves (Di Luzio, 2015).

The Psychology of Anorexia Nervosa

Anorexia nervosa patients get fulfillment for self-object needs by avoiding food. Rather than meeting self-object needs through positivity or approval from important people, like friends or family, anorexic patients find a different route. Instead, it is from this idea that limiting food intake or not eating at all gives them supernatural powers and the ability to conquer anything, including life struggles (Di Luzio, 2015). Anyone who meets an anorexia nervosa patient notices their feelings of great success that comes with every pound they lose.


“Nervosa,” by Schon! Magazine is in the Public Domain.

To treat this unhealthy form of self-object needs, Kohut suggests that therapists develop a mindset where they share and understand the feelings of their patients when talking to them (Di Luzio, 2015). When a therapist is able to see and understand a person’s concerns through their point of view, also known as experience-near observation, treatment may move forward more readily and effectively. Although, another idea Kohut has suggested that may come across as an oxymoron if anything is promoting “healthy narcissism” (Di Luzio, 2015). Healthy narcissism is the ability to have realistic self-esteem and self-worth without denying oneself of positive relationships with other people (Brechan, 2015). When developing this type of mindset, individuals are able to develop positive reinforcement within themselves and do not have to rely on avoiding food as a self-object need.

The Psychology of Binge Eating

The link between appetite, hunger, and fullness with the reward system can be viewed as a basis for the development of addictive-like eating behavior (Hebebrand et al., 2014). This combination can lead to overeating, leading to obesity. Psychological signals like boredom, stress, or a negative mood swing can potentially trigger overeating foods in one sitting, even when a person is not really hungry (Hebebrand et al., 2014). Impulsivity towards food has been identified as a potential factor leading to increased food intake in obesity (Schag et al., 2013). Patients suffering from binge eating disorder are a specific group of obese people that might be categorized by increased impulsivity (Schag et al., 2013). There are two components of impulsivity: patterns for reward sensitivity, like the urge to consume something, and rashness, behaviors that are not well thought-out, and do not pay attention to the consequences of overeating (Schag et al., 2013). Binge eating disorders are typically triggered by traumatic events an individual has during their childhood (Bryant-Waugh et al., 2010). In this case, binge eaters get their self-object needs through the positive feeling they get when consuming a large amount of food or foods high in calories.

Pleasant tasting and often high-calorie foods are readily available and easily obtained. To maintain a healthy lifestyle, a degree of self-control is needed to overcome temptation towards these unhealthy options. Overcoming temptation or urges requires the ability to withhold unwanted behavior, which is referred to as inhibitory control (Bartholdy, 2016). Therefore, lacking inhibitory control plays a role in the development of obesity. This can include the inability to control urges to binge eat or to purge.


“A Story About Binge Eating Disorder,” by Coat of Arms is licensed under CC BY-NC-ND 3.0.

To control impulsivity and poor inhibitory control, looking for a hobby, seeking support from family and friends, and creating realistic, achievable goals can promote healthy eating behaviors (Schag et al., 2013). By replacing the self-object need for overeating with positive activities and relationships, people can mirror those good thoughts within themselves.


When taking into consideration the motives of why people eat, it’s important to understand the psychology behind it. Particularly, therapists, physicians, family, and friends should develop an empathetic attitude when discussing abnormal eating patterns with someone who struggles with an eating disorder. This can include positive reinforcement, suggesting activities, creating realistic goals, or by just simply offering a listening ear. By doing so, a healthy approach to seeking comfort from past trauma or experiences can develop.


Review Questions

1. What part of an individual’s life is most important for developing a healthy sense of “self”?
a. Childhood
b. Puberty
c. College Years
d. Adulthood 

2. What is the ability to have realistic self-esteem and self-worth without being cut off from positive relationships with other people called?
a. Realism
b. Healthy Egoism
c. Healthy Narcissism
d. Mirroring Self-object Needs

3. What is NOT a potential trigger that can cause an individual to overeat?
a. Stress
b. Traumatic Event
c. Negative Mood Swing
d. Good Inhibitory Control


Bartholdy, S. (2016). A systematic review of the relationship between eating, weight, and inhibitory control using the stop-signal task. Neuroscience & Behavioral Reviews, 64, 35-62. https://doi.org/10.1016/j.neubiorev.2016.02.010

Brechan, I. (2015). Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eating Behaviors, 17, 49-58. https://doi.org/10.1016/j.eatbeh.2014.12.008

Bryant-Waugh, R., Markham, L., & Kreipe, R. (2010). Feeding and eating disorders in childhood. International Journal of Eating Disorders, 43, 98-111. https://doi-org.libproxy.clemson.edu/10.1002/eat.20795

Di Luzio, G. (2015). Considerations on self-psychology and eating disorders. Eating and Weight Disorders – Studies on Anorexia, Bulimia, and Obesity, 20, 427-433. https://doi-org.libproxy.clemson.edu/10.1007/s40519-015-0216-x

Hebebrand, J., Albayrak, O., & Adan, R. (2014). “Eating addiction” rather than “food addiction”, better captures addictive-like eating behavior. Neuroscience Biobehavioral Review, 47, 295-306. https://doiorg.libproxy.clemson.edu/10.1016/j.neubiorev.2014.08.016

Schag, K., Schönleber, J., & Teufel, M. (2013). Food-related impulsivity in obesity and binge eating disorder: A systematic review. Obesity Reviews, 14, 477-495. https://doi-org.libproxy.clemson.edu/10.1111/obr.12017



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An Ecological Approach to Obesity and Eating Disorders Copyright © 2020 by Katie Yacu is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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