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Feeling Lonely and Struggling with Anorexia? Here’s Why

Nearly all of my clients that struggle with anorexia tell me that they are lonely. This could sound like:
• “I’m struggling to find friends.”
• “I have trouble connecting with others.”
• “I can’t go, because I don’t have a life, and wouldn’t have anything to talk about.”
• “I never know what to say.”
• “People don’t like me.”

The biggest worry I hear is that he or she will be at an event where food is served, which is most places and most events. Birthdays, holiday parties, backyard nights with the neighbors, family gatherings and the list goes on.

What Not Eating Signals to Others
Not eating when others eat is a huge social signal. A social signal is something that another person can see us do (or in this case not do). If I am sitting at a friend’s graduation dinner, and order a salad, but don’t eat it, I’m not fooling anyone. People can see that I’m not eating and probably I am making all kinds of micro expression that indicate stress.

As much as many of my clients think they are hiding it, the research shows humans are excellent social safety detectors. This means that when someone is feeling threatened or stress, we know it – by the flat or shrill tone of their voice, a rigid or flat expression, or body tension.

When a person doesn’t eat when others are, it signals that something is wrong. It also says, “I’m not like you.” Which is usually the last thing that people struggling with anorexia want to be seen as — different or out of the tribe.

Signal vs Intention
Let’s say that at the graduation dinner my intention was to go and show support for my friend Whether I like it or not, one of the ways that I can show support is to participate in the same activity that others are. In this case sharing a meal. Breaking bread is a hugely social activity shared between tribe members. When we share a meal, it says, “Hey, you’re with me.”

How to Get Help
The good news is that Radically Open Dialectical Behavior Therapy (RO DBT) has found a way to help many individuals emerge from the anorexia trap. Taking the lead from what is psychologically health in all humans – the desire to be with others – is where the therapy starts. Learning to eat to be tribal is a different approach than many therapies and one that has been proven to work in wonderful eating disorder treatment centers like Maudsley and in many out-patient settings.


For additional reading:

Hempel, R.J., Vanderbleek, E., Lynch, T.R. (2018). Radically Open DBT: Targeting Emotional Loneliness in Anorexia Nervosa. Eating Disorders: The Journal of Treatment and Prevention, 26(1), 92-104.

Feeling Lonely and Struggling with Anorexia? Here’s Why

Hope Arnold

Hope is a Radically Open DBT Senior Clinician and 1-day trainer for Radically Open LTD organization. As a self identified overcontrolled person, she works to help her clients learn to relax, take themselves less seriously and be the person they want to be. Perfectionism, anxiety, rigidity, detailed focus, risk aversion and loneliness are some of the areas that overcontrolled people struggle to navigate. In her writing Hope uses humor and real life stories to help overcontrolled individuals make the changes that will bring happiness to their lives. Hope is licensed as a LCSW in Colorado, Texas, and Virginia. She has a private practice in Denver, Colorado.

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APA Reference
Arnold, H. (2018). Feeling Lonely and Struggling with Anorexia? Here’s Why. Psych Central. Retrieved on July 10, 2020, from


Last updated: 1 Dec 2018
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