EMDR Therapy for Eating Disorders in Austin, Texas

A trauma-informed adjunct to eating disorder therapy and nutrition therapy.

Eating disorders are treatable, and they often require more than one clinical lens. Treatment with Austin Center for Eating Disorders (ACED) is built for the full picture: eating disorder symptoms, body image distress, anxiety and OCD features, trauma exposure, identity stressors, and the practical realities of daily life. ACED is explicitly aligned with Health at Every Size® and Intuitive Eating, grounded in body liberation and anti-oppressive frameworks, and committed to affirming care for LGBTQIA+ and gender diverse clients.

Eye Movement Desensitization and Reprocessing (EMDR) can support eating disorder recovery when trauma, chronic symptoms of anxiety or vigilance, or persistent feelings of shame are part of the clinical picture. EMDR is not positioned here as a standalone eating disorder treatment. EMDR is an adjunctive modality that can strengthen and sustain recovery when integrated with evidence-based eating disorder therapy, nutrition therapy, and medical monitoring when indicated.

What is EMDR?

EMDR is a structured psychotherapy developed to treat trauma-related symptoms. It follows an eight-phase, protocol-driven approach and is guided by the Adaptive Information Processing (AIP) model, which proposes that symptoms can persist when distressing experiences are insufficiently processed and remain stored with their original emotional intensity, beliefs, and body sensations (Shapiro, 2018; Hase et al., 2021).

In EMDR, the client briefly brings a target memory or trigger to mind while engaging in bilateral stimulation (often eye movements, tapping, or alternating tones). The clinical aim is to reduce distress, shift maladaptive beliefs, and change the nervous system response to present-day cues that previously functioned as threat signals (Shapiro, 2018; U.S. Department of Veterans Affairs, 2024).

EMDR is included in PTSD treatment guidance as a recommended or suggested psychotherapy, reflecting a strong evidence base for PTSD and trauma-related symptoms (American Psychological Association, 2017; U.S. Department of Veterans Affairs, 2024).

Why EMDR belongs in an eating disorder recovery

Eating disorder behaviors can function as survival strategies. Restriction, binge eating, purging, compulsive exercise, body checking, and rigid rules often regulate distress quickly, even when they cause long-term harm. In clinical practice, these behaviors commonly track with threat physiology: hyperarousal, shutdown, dissociation, and cycles of shame that feel bodily and automatic.

Trauma exposure and PTSD occur at elevated rates among individuals with eating disorders, and comorbidity can complicate the course of treatment if trauma-related mechanisms are not addressed (Brewerton, 2023; Ouyang et al., 2025).

EMDR becomes clinically relevant when eating disorder symptoms are maintained by:

• trauma memories tied to food, eating, bodies, medical experiences, or being seen

• persistent body-based threat responses (panic, nausea, disgust, numbness, shutdown)

• chronic feelings of shame that do not shift with insight alone

• entrenched beliefs such as “I’m unsafe,” “I’m disgusting,” “I must control my body to be acceptable”

• triggers that reliably produce eating disorder urges (e.g., mirrors, clothes, fullness, photos, conflict, intimacy, comments)

• dissociation that disrupts interoception (the felt experience of hunger and fullness), emotion recognition, or consistent nourishment

In these contexts, EMDR can reduce the reactivity that drives symptoms, and can improve the client’s capacity to engage fully in eating disorder recovery tasks.

What the research says about EMDR for eating disorders

The evidence base for EMDR in PTSD is robust. The evidence base for EMDR as an eating disorder adjunct is emerging, with promising findings and clear limits.

Key findings that inform clinical practice include:

• EMDR and negative body image in eating disorder inpatient care:
  A randomized experimental study in an inpatient eating disorder setting found that adding EMDR to standard residential treatment improved aspects of negative body image and related outcomes (Bloomgarden & Calogero, 2008).

• EMDR as an add-on to CBT-E in anorexia nervosa with childhood maltreatment:
  A quasi-experimental study compared CBT-E alone versus CBT-E plus EMDR for patients with anorexia nervosa reporting moderate to severe childhood maltreatment. The study supports EMDR as a potentially useful adjunct for a trauma-exposed subgroup, while also reflecting the need for additional randomized trials (Rossi et al., 2024).

• Systematic review of EMDR for eating disorders:
  A 2024 systematic review evaluated the available evidence for EMDR in eating disorders, describing promise while emphasizing limitations such as small sample sizes, variable protocols, and heterogeneity in outcomes (Hatoum et al., 2024).

• Trauma, PTSD, and eating disorder treatment implications:
  Clinical and review literature highlights that trauma and PTSD can influence eating disorder outcomes and argues for integrated treatment attention to trauma-related mechanisms within eating disorder care (Brewerton, 2023; Ouyang et al., 2025).
  
  

Clinical takeaway: EMDR is best positioned as an adjunctive intervention for eating disorder recovery when trauma-related symptoms, body-based threat responses, or persistent shame are maintaining symptoms. It is not a substitute for nutrition rehabilitation, medical stabilization, and evidence-based eating disorder psychotherapy.

How EMDR helps in eating disorder recovery: mechanisms that matter clinically

EMDR can support eating disorder recovery in several ways that are particularly relevant to ED behavior maintenance. These mechanisms often overlap.

1. Reduced threat activation that drives symptom urgency:
   When eating, fullness, body exposure, or relational cues activate the nervous system as “danger,” eating disorder behaviors can become the fastest exit ramp. EMDR targets the memory networks feeding that threat response so present-day triggers carry less physiological intensity (Shapiro, 2018; U.S. Department of Veterans Affairs, 2024).

2. Shifts in shame-based beliefs:
   Eating disorders frequently attach to beliefs about worth, safety, and belonging. EMDR explicitly targets the memory-belief-body loop, which can loosen shame that remains sticky even in highly insightful clients (Shapiro, 2018; Hase et al., 2021).

3. Body image triggers treated as stored experience:
   Body image distress is often sensory and somatic, not only cognitive. EMDR can target formative experiences such as harassment, family criticism, medical trauma, objectification, and weight stigma. Controlled evidence supports EMDR’s potential to improve negative body image outcomes in ED treatment contexts (Bloomgarden & Calogero, 2008).

4. Increased tolerance for interoceptive cues:
   For clients whose hunger, fullness, nausea, or physiological arousal have become threat cues, EMDR can reduce conditioned panic responses and support more consistent nourishment and flexibility with eating (Shapiro, 2018).

5. Improved capacity to use skills and sustain behavior change:
   When trauma-related distress decreases, clients often have more bandwidth for eating disorder exposures, meal plan structure, distress tolerance, relational work, and values-based choices. This is one reason EMDR can be especially useful when integrated with CBT-E, DBT skills, ACT, ERP, and nutrition therapy rather than used in isolation.

What EMDR looks like when integrated into outpatient eating disorder care

An EMDR approach in eating disorder treatment is paced and prioritizes stabilization. This approach respects that eating disorders can intensify when the nervous system is overloaded or when nutritional status is compromised.

An example plan might involve:

Comprehensive assessment and treatment planning
Assessment considers eating disorder severity, medical risk, nutrition status, trauma symptoms, dissociation, comorbid anxiety/OCD, substance use, self-harm risk, and current supports. ACED’s broader treatment model emphasizes that eating disorders often require a coordinated team (therapist, dietitian, medical provider), especially when symptoms affect health and functioning.

Preparation and resourcing
Preparation is a core component of EMDR and often expands in ED work. This phase builds skills that support stabilization before and after reprocessing, including grounding, containment strategies, nervous system regulation, and clear pacing agreements (Shapiro, 2018; U.S. Department of Veterans Affairs, 2024).

Target selection with an eating disorder formulation
Targets are chosen to support eating disorder recovery goals. Common targets include:

• body-shame memories (comments, bullying, humiliations, medical encounters)

• trauma tied to safety in the body (boundary violations, coercion, assault, harassment)

• relational injuries connected to worth and belonging

• moments that reinforced “control = safety” or “being seen = danger”

• present triggers that reliably escalate eating disorder urges (photos, mirrors, clothing, fullness)

• future templates for anticipated stressors (holidays, weddings, travel, medical visits, dating, returning to school)

Reprocessing with close monitoring
Reprocessing is delivered within the client’s window of tolerance, with ongoing monitoring for dissociation, overwhelm, and spikes in eating disorder behaviors. In outpatient ED treatment, reprocessing often alternates with stabilization and symptom-focused work.

Integration into daily recovery tasks
Integration connects progress won in EMDR back to recovery behaviors: consistent nourishment, flexibility with food rules, reduction of compensatory behaviors, decreased body checking, improved boundary setting, and greater tolerance for being seen.

When EMDR is not the first step

Timing matters. EMDR is most effective when the brain and body have the capacity to integrate information, which is influenced by nutrition, sleep, stability, and safety.

EMDR is often delayed, modified, or used cautiously when:

• medical instability is present

• severe malnutrition is impairing cognition, affect regulation, or somatic tolerance

• purging or high-risk behaviors are not stabilized

• severe dissociation is not adequately supported

• active substance dependence is unmanaged

• current environment includes ongoing trauma without safety planning

• the eating disorder is functioning as the primary emotion regulation strategy and alternative supports are not yet established

In these situations, the clinical priority is stabilization, which could mean a higher level of care assessment when indicated, nutrition rehabilitation, medical monitoring, skills development, and environmental supports. EMDR can be integrated once stability increases and reprocessing is more likely to help than destabilize.

EMDR, body liberation, and weight-inclusive care

Austin Center for Eating Disorders’ values are explicitly weight-inclusive and rooted in body liberation, anti-oppressive frameworks, and social justice ideals.

That is important when considering EMDR because a large portion of body-based distress is shaped by culture, stigma, and repeated interpersonal experiences. Weight stigma and thin-ideal pressure are not neutral exposures. They can be chronic sources of threat and shame. EMDR does not “remove” structural harm, and it does not reframe oppression as an individual cognitive distortion. It can, however, reduce the internalization of harm and help clients reclaim choice and safety in their bodies.

In practice, this can look like targeting:

• weight-based discrimination experiences and their aftereffects

• medical dismissal and shame in healthcare settings

• harassment and objectification linked to avoidance or dissociation

• identity-based stressors that have become embedded as “I don’t belong” beliefs

This work is most effective when paired with explicit naming of weight stigma, dismantling diet culture narratives, and building body-respect practices that match the client’s values and lived realities.

EMDR with nutrition therapy: how integration improves outcomes

Eating disorder treatment tends to be most effective when therapy and nutrition therapy are collaborative. The Austin Center for Eating Disorders model emphasizes coordinated outpatient support and a multidisciplinary approach, including specialized dietitians as part of recovery care.

EMDR supports nutrition work in several practical ways:

• reduced panic around fullness and body sensations

• decreased shame that drives restriction, secrecy, or compensatory behavior

• improved capacity for meal plan consistency during stress

• less reactivity to food exposures and social eating

• greater tolerance for body changes that can occur during recovery

Nutrition therapy supports EMDR work by increasing stabilization and nervous system resilience. When clients are undernourished, the capacity for integration and emotional regulation is reduced. Coordination between the ED treatment helps the treatment plan remain both safe and effective.

What to expect if EMDR is part of your treatment plan at ACED

The first phase typically looks like assessment and collaborative planning. Sessions focus on clarifying goals and ensuring the plan matches your level of care needs. If EMDR is a fit, preparation comes before reprocessing. This includes skill-building for grounding, regulation, and between-session support.

EMDR work is paced and integrated. Sessions may alternate between:

• eating disorder symptom work (food rules, exposures, relapse prevention, skills)

• trauma processing targets

• body image interventions and practical support for daily functioning

• coordination with your dietitian and, when needed, your medical provider

ACED also emphasizes client autonomy and collaboration in care planning, including pacing and length of treatment.

Indicators that EMDR may be a clinically strong fit

EMDR may be appropriate to consider when these patterns are present:

• eating disorder symptoms reliably intensify after trauma reminders or relational stress

• body image distress is accompanied by strong physiological activation (felt symptoms of panic or anxiety) or shutdown

• shame and self-attack remain persistent despite insight and effort

• triggers produce disproportionate reactions that feel automatic rather than chosen

• dissociation interferes with recognizing hunger/fullness, emotion, or safety cues

• treatment progress repeatedly collapses during stress, conflict, or exposure to being seen

• trauma symptoms (intrusions, avoidance, hyperarousal) are clearly present alongside ED symptoms

Clinical fit always depends on stability, safety, and a clear integration plan.

Frequently asked questions - FAQs

Does EMDR require talking in detail about trauma?
EMDR is not an exposure narrative therapy that requires extended verbal recounting. Clients identify targets and engage in structured processing. The level of verbal detail is collaborative and titrated (Shapiro, 2018; U.S. Department of Veterans Affairs, 2024).

Can EMDR help with binge eating?
Emerging evidence supports ongoing study of EMDR for binge eating presentations and trauma-linked mechanisms (Hatoum et al., 2024). A clinician will still assess for additional components that are often essential in binge eating recovery, including regular eating structure, restriction reversal, skills work, and nutrition therapy.

Can EMDR be used with anorexia nervosa or severe restriction?
EMDR can be appropriate as an adjunct when medical stability and nutritional status support safe processing, especially when trauma history is clinically relevant. Research on EMDR as an add-on to CBT-E in anorexia nervosa with childhood maltreatment supports this adjunctive direction while underscoring the need for careful pacing and more trials (Rossi et al., 2024).

How long does EMDR take?
Length varies by complexity and goals. PTSD-focused EMDR is often delivered weekly over a course of weeks to months, with flexibility for longer or shorter care depending on needs (U.S. Department of Veterans Affairs, 2024). In eating disorder care, EMDR is frequently integrated over time alongside nutrition and symptom-focused work rather than delivered as a single uninterrupted block.

Could EMDR make symptoms worse?
Any trauma-focused treatment can temporarily increase emotional intensity. The risk is reduced by solid preparation, careful pacing, and an integrated treatment plan that supports nutrition, stabilization, and between-session coping (Shapiro, 2018). Symptom spikes are treated as clinical data that guide pacing and support levels rather than as failure.

EMDR therapy for eating disorders in Austin, Texas: how to begin

ACED provides outpatient therapy and nutrition therapy in Austin, Texas, with virtual and in-person options, and a team grounded in weight-inclusive, affirming, and socially conscious care.

A strong next step is a consultation focused on fit, stability, and goals, including:

• eating disorder symptoms and level of care needs

• medical and nutrition stability

• trauma symptoms and dissociation screening when indicated

• whether EMDR is appropriate now or later in the treatment plan

• whether additional supports are needed (dietitian, physician, psychiatry, group)

References

American Psychological Association. (2017). Eye movement desensitization and reprocessing (EMDR) therapy. APA PTSD Clinical Practice Guideline treatment resources.

Austin Center for Eating Disorders. (2026). About ACED: Our philosophies and practices.

Austin Center for Eating Disorders. (2026). Eating disorder treatment FAQs.

Austin Center for Eating Disorders. (2026). Eating disorder treatment basics: Evidence-based recovery and treatment options in Austin and Texas.

Austin Center for Eating Disorders. (2026). Nutrition therapy for eating disorders.

Bloomgarden, A., & Calogero, R. M. (2008). A randomized experimental test of the efficacy of EMDR treatment on negative body image in eating disorder inpatients. Eating Disorders, 16(5), 418–427.

Brewerton, T. D. (2023). The integrated treatment of eating disorders, posttraumatic stress disorder, and psychiatric comorbidity: A commentary on the evolution of principles and guidelines. Frontiers in Psychiatry, 14, 1149433.

Hase, M., Balmaceda, U. M., Ostacoli, L., Lieberman, S., & Hofmann, A. (2021). The structure of EMDR therapy: A guide for the therapist. Frontiers in Psychology, 12, 660753.

Hatoum, A. H., et al. (2024). Eye movement desensitization and reprocessing (EMDR) therapy for the treatment of eating disorders: A systematic review of the literature. Mental Health Science, 1(2), e92.

Ouyang, H., Wang, Y., & Chen, J. (2025). From shared mechanisms to treatment gaps: A review of the comorbidity between eating disorders and PTSD. Journal of Eating Disorders, 13(1), 271.

Rossi, E., et al. (2024). Eye movement desensitisation and reprocessing as add-on treatment to enhanced cognitive behaviour therapy for patients with anorexia nervosa reporting childhood maltreatment: A quasi-experimental study. European Eating Disorders Review.

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

U.S. Department of Veterans Affairs. (2024). Eye movement desensitization and reprocessing (EMDR) for PTSD. National Center for PTSD.

Legal disclaimer: The ACED team is comprised of mental health professionals licensed to practice in the state of Texas. Reading our blog does not create a therapist-client relationship between us. Our blog is designed for informational purposes only, and is not intended as a substitute for professional care. The contents of this blog should not be used to diagnose or treat illness of any kind, and before you rely on any information presented here you should consult with a trusted healthcare professional. If you are currently experiencing a mental health emergency please call 911 or the National Suicide Prevention Hotline at 1-800-273-8255.