55 Eating Disorder Interview Questions To Ask Clients in Therapy Sessions

Eating disorders are an example of a mental health condition that is not always understood by the public. In truth, there are several eating disorders that individuals can experience that are related to their health, weight, appearance, body shape, and more. All of which are biologically influenced illnesses that can have long-lasting health implications. Keep reading to learn 55 eating disorder interview questions you can ask your clients in therapy sessions.

Eating disorders can affect, truly, anyone. Regardless of their age, racial or ethnic background, weight, gender, and where they live. For many, symptoms associated with eating disorders can begin during teen years, it can also develop later in life, including at 40 years and older. Research has not been able to pinpoint the exact causes for eating disorders; however, it has indicated that it can be due to a combination of genetic, biological, behavioral, psychological, and social factors.

Before we get into the different eating disorders you may encounter in your clinical practice, we want to stress the fact that individuals with eating disorders may appear healthy; however, they can be experiencing significant mental and physical health concerns.

Anorexia nervosa is often the type of eating disorder that comes to mind when talking about them. With this condition, individuals avoid food, eat small quantities of particular foods, or restrict their food intake completely. The two types of anorexia nervosa include restrictive and binge-purge subtypes. Anorexia can cause severe and permanent health concerns, and in some cases, can be fatal.

Bulimia nervosa is characterized by recurrent episodes of consuming large amounts of food and feeling out of control over eating patterns during these episodes. Binges are followed by compensatory behaviors such as excessive exercise, the use of laxatives or diuretics, and forced vomiting. Individuals who struggle with binge-eating can experience significant health risks including severe dehydration, electrolyte imbalance, and gastrointestinal issues. Individuals may be able to maintain their weight, or may be overweight.

Binge-eating disorder is a condition where individuals lose control over their food consumption and have recurrent episodes of consuming large amounts of food. The key difference between bulimia nervosa and binge-eating disorder is that there are no compensatory behaviors after binges, which typically causes individuals to be overweight.

Avoidant restrictive food intake disorder (ARFID) is more common during childhood, and can later develop into other eating disorders. ARFID is characterized by individuals limiting the amount, or types, of food that they eat. These individuals do not have a distorted perception of themselves and their body, a factor that differentiates this from anorexia nervosa. ARFID should not be confused with picky eaters; children with ARFID often consume such a low calorie amount that their growth and development can be negatively affected.

The National Eating Disorder Association indicated that over 28 million Americans will struggle with an eating disorder at some point in their lifetime, and that rates are higher among women than men. Eating disorders are believed to affect 22% of children and adolescents globally. Additionally, one person dies due to the consequences of an eating disorder every 52 minutes. 

One of the most valuable treatment components for eating disorders is early detection and treatment. Individuals who are experiencing an eating disorder are known to have a higher risk for suicide and physical health concerns.

Treatment programs often include family members and other loved ones because they can be a valuable source of support, and be an ally for healthcare professionals. Research has indicated that treatment outcomes for adolescents experiencing an eating disorder are greater when family members are incorporated into treatment.

Treatment approaches for eating disorders often include a combination of interventions including psychotherapy, medical supervision and care, nutritional counseling, medications for physical health concerns, and in some cases, psychotropic medications to help manage symptoms associated with eating disorders and co-occurring diagnoses. 

Getting Ready for Your First Therapy Session with a New Client with an Eating Disorder

Preparation for your first session will be dependent on the level of care that you provide and your role in the treatment facility. Professionalswho complete intake assessments in an inpatient psychiatric program will have a different routine than clinicians providing psychotherapy in a routine outpatient clinic. Regardless, taking time to review the documentation that you have received before your session can be informative, and allow you to develop a rough road map for your session.

Depending on the services you are provided, it may be helpful to collect the various documents or related paperwork that you will be completing. This allows for smooth transitions, and can save you time in session. If your first session with a client is a therapy or counseling session, you may find that pulling out related worksheets is useful. Worksheets can be a valuable tool in clinical sessions by aiding in the facilitation and progression of therapeutic sessions, in addition to providing clients with a resource they can take home.

TherapyByPro provides access to worksheets that can be used for various mental health concerns. Examples of available worksheets that could be useful for clients who are living with an eating disorder include:

• DBT Worksheet Bundle
• Eating Disorder Worksheet Bundle
• Body Image Worksheet Bundle
• Eating Disorder Relapse Prevention Plan Worksheet

Eating Disorder Interview Questions to Ask Clients

Whether you’re conducting an intake assessment, or facilitating psychotherapy, eating disorder questions can be a useful way to learn about your clients’ experiences and current challenges. You may find that your use of  eating disorder interview questions helps you develop a comprehensive treatment plan, including realistic and attainable goals. With the use of non-judgmental and thoughtful questions, you can create a safe and welcoming environment for your clients to freely express their thoughts and emotions. Continue reading for examples of questions to ask someone living with an eating disorder!

1. Could you please describe what a typical day of eating includes for you?
2. How would you describe your relationship with food?
3. Are there any rituals or routines around meals or eating that you engage in?
4. Can you tell me about any foods or food groups that you avoid?
5. How do you respond to feeling hunger and fullness cues?
6. Have you noticed changes in your appetite or eating habits recently? Can you think back to when these changes began?
7. How often do you find yourself thinking about food or your weight throughout a typical day?
8. Do you ever find yourself eating because of emotional distress? Which  emotions do you find the most triggering?
9. Have you ever engaged in binge-eating or felt as though you lost control while eating?
10. Can you think of any triggers or situations that lead to disordered eating behaviors?
11. How do you feel about your body and appearance?
12. Can you think of a time when you felt comfortable in your own skin?
13. Have you noticed any changes in your body image over time?
14. Do you compare your body size or shape to others, either in person or through social media?
15. Are there certain body parts you’re preoccupied with or feel particularly insecure about?
16. How do you feel that your perception of your body impacts your self-esteem?
17. Have you experienced any criticism or negative remarks about your body from others?
18. What is beauty and attractiveness to you?
19. Can you think of any behaviors you have engaged in, or currently do, in an attempt to alter or control your body shape or size?
20. How do you cope with feelings of dissatisfaction or discomfort with your body?
21. How do you typically cope with stress or difficult emotions?
22. How effective would you say your current coping skills are when you are feeling distressed?
23. Have you noticed any changes in your mood or emotions recently, including moodiness or irritability?
24. Can you tell me about who you tend to talk to when you’re struggling or feeling stuck?
25. Can you think of any traumatic events or significant life changes that may be affecting your emotional well-being?
26. How do you express emotions such as sadness, anger, or anxiety?
27. Are there any experiences or traumas that you feel may be connected to your eating disorder?
28. Would you kindly tell me about any previous or current self-destructive or self-harm behaviors you have engaged in?
29. What activities or hobbies do you find enjoyable or fulfilling?
30. Are there any healthy coping strategies or relaxation techniques you’ve found helpful when feeling distressed, overwhelmed, or triggered?
31. How do you feel that your eating behaviors and body image concerns affect your relationships with others?
32. Are there social situations or events that trigger anxiety or discomfort around food for you?
33. Do you feel pressure from anyone in your life about your eating habits or appearance?
34. How do you navigate social gatherings or meals with others?
35. Have you experienced any changes in your social life or friendships as a result of your eating disorder?
36. Are there any relationship dynamics or conflicts that you feel are contributing to your disordered eating behaviors?
37. Can you tell me about how you communicate your needs and boundaries with others?
38. Do you feel supported by those important to you in your recovery journey?
39. Have you noticed any physical symptoms or changes in your health recently that could be tied to your disordered eating?
40. Have you experienced any gastrointestinal issues, such as bloating, constipation, or acid reflux?
41. How would you describe your energy level and overall physical stamina?
42. Do you have any concerns about your menstrual cycle or reproductive health?
43. Do you experience dizziness, fainting, or lightheadedness?
44. Are you currently taking any medications or supplements that affect your appetite or weight?
45. Have you sought medical attention or treatment for any eating disorder-related health concerns in the past, and if so, what symptoms were you experiencing?
46. Do you know if you have a family history of eating disorders or mental health conditions?
47. Would you mind sharing with me your experiences with abuse, neglect, or trauma?
48. How do you feel that past relationships or family dynamics influenced your relationship with food and body image?
49. Can you tell me about what you would like to gain from counseling, and work towards in your recovery?
50. What would success or progress look like in your recovery journey?
51. What motivated you to get help to make changes in your eating behaviors?
52. Are there any barriers or challenges you anticipate facing in your recovery process?
53. Are there any specific skills or tools you hope to develop through therapy?
54. Are there any recurring thoughts or beliefs that contribute to your disordered eating behaviors?
55. How would you describe your self-talk patterns about food, weight, and body image?

Final Thoughts on Eating Disorder Questions to Ask Clients

Let us take a moment to thank you for your interest in our blog about questions to ask someone with an eating disorder! Mental health professionals who provide psychotherapy and related services to those living with eating disorders have an important role in addressing the complex nature of an eating disorder, utilizing specialized knowledge and expertise experiences. The clinical work done with a client can help them form a healthy relationship with food and improve their body image, which for some, may be a new life experience.

If you would like to learn more about the complex nature of eating disorders and evidence-based treatments that are often utilized by eating disorder treatment providers, we encourage you to inquire about for continuing education and other training opportunities designed for your niche within the mental health field.

Resources:

• “Eating Disorders: About More than Food.” National Institute of Mental Health. Accessed March 12, 2024. https://www.nimh.nih.gov/health/publications/eating-disorders#:~:text=Common%20eating%20disorders%20include%20anorexia,avoidant%20restrictive%20food%20intake%20disorder.
• “Eating Disorder Statistics.” National Eating Disorders Association, March 8, 2024. https://www.nationaleatingdisorders.org/statistics/.
• Kass, Andrea E et al. “Psychological treatments for eating disorders.” Current opinion in psychiatry vol. 26,6 (2013): 549-55. doi:10.1097/YCO.0b013e328365a30e