Outdoor Eating Disorder Therapy in Sheffield

Often, people I work with have already explored the diagnostic criteria for an eating disorder but still have questions. Whether a label resonates exactly for you, or you just know that you struggle with food, eating disorder therapy can help. I work with restrictive eating, bingeing, bulimia and ARFID, and anyone who has a difficult relationship with food but doesn’t meet all the criteria for one of these. Most people with eating disorders don’t really fit neatly into one of the labels, and many people I work with don’t either.

Working outdoors can give you the opportunity to connect with your body in a different way. Being in nature can help the focus to move away from how you look towards how you feel: steady on uneven ground, warm from walking, or cold in the wind. Research in this area is still fairly small, but time spent outdoors has been linked with improvements in body image and self-esteem for people recovering from eating disorders.

Working outdoors can give you the opportunity to connect with your body in a different way. Being in nature can help the focus to move away from thoughts and feelings that make you feel trapped, and help you to be more in the present. Many people with eating disorders feel quite disconnected from what’s happening inside their body (things like hunger cues, physical needs or what emotions they are feeling). Outdoors, we can start with what’s around us: the wind on your face, the sun on your skin or the ground under your feet. Over time, this can help you to tune in to and understand your body and your emotions.

Can eating disorder therapy work outdoors?

The honest answer is sometimes, but not always.

Benefits of eating disorder therapy outdoors

For some people, it can work really well. Talking about food, eating and your body can feel exposing, and sitting face to face in a room can be scary. Walking side by side or simply sharing the space while doing something takes some of the pressure off and can feel less judgemental.

Eating disorders are often about control, but underneath that there is often a lot of fear. Being outdoors can give you a chance to change the way you connect with your body. It can also help you build trust in your body and confidence that you can rely on it.

When it isn’t appropriate

Outdoor therapy isn’t always the right fit for eating disorders, and it’s something I would think about carefully with you in our assessment.

Walking is a big part of how I work outdoors. If exercise has become tied up with your eating disorder walking in sessions can feed into that rather than support recovery. Physical health is also something I take into consideration. If you are under-fuelled, being cold, wet or too hot can make it very hard to process and put you at risk.

Some of the work involves writing things down or looking at things together, like going through a food diary. There are various ways we can integrate outdoor therapy into this work, like starting indoors and moving outdoors or splitting our time between the room and outside.

If you want to work outdoors, get in touch with me and we can talk about what might work for you.

Why specialist eating disorder therapy is important whether indoors, online or outdoors

Therapy for eating disorders has a lot of research and evidence behind it, and just talking about it isn’t enough. My work is grounded in evidence and specialist training, and looks at the whole picture: food and the feelings together. The rest of this page explains what eating disorders can look like, how I work, and what to expect from therapy.

Do I have an Eating Disorder?

Eating disorders are about how you think, feel and behave around food.

There are various thoughts, feelings and behaviours that are common eating disorders, and these are what I would look for in an assessment session. I’m not expecting you to tick all these boxes, but I imagine that you might recognise some of them. Sometimes it only takes one of these to have a big impact on your life.

Thoughts that are common in eating disorders

• Do you spend a lot of time thinking about food, calories or your weight?
• Do you often compare how you look or what you eat to the people around you?
• Do you follow strict rules about what you should or shouldn’t eat?
• Do you worry that once you start eating, you won’t be able to stop?
• Do you feel fat when you eat something you shouldn’t?

Feelings you might experience

• Do you feel scared, anxious or guilty before or after eating?
• Does how you eat affect how you feel about yourself?
• Does you ever feel out of control around food?

Eating disorder behaviours

• Do you eat differently in front of other people to when you’re alone?
• Do you ever make yourself sick, or use laxatives or exercise to make up for what you’ve eaten?
• Do you restrict what you eat because it feels like you have no choice, or get caught in cycles of restricting and overeating?
• Do you exercise to make up for what you have eaten?
• Do you weigh yourself a lot, or avoid weighing yourself at all?

If the answer to any of these is yes, eating disorder therapy can help. You don’t have to have a diagnosis, be in crisis, or to look a certain way.

How Eating Disorder Therapy can Help

This looks different for everyone, depending on your goals. Things I work towards with clients often include:

• Food no longer taking up so much space or having so much power over how you feel.
• The food noise (or food voice) can become quieter, and constant background thoughts about what to eat, what you have eaten, and when you will eat can become quieter with that.
• Being able to eat out, or eat with friends, without worries about food taking over.
• Finding ways to manage emotions without food.

Working with food issues is hard at times, but people can and do see real change with the right support.

Understanding the whole picture

Humans have always eaten emotionally, and not just out of need. Eating disorders aren’t just about food or just about feelings: they’re about both. Experiences like trauma, depression, anxiety, loss, difficult relationships or overwhelming emotions can make someone vulnerable to an eating disorder. You might not know how it started.

Neurodivergence, like autism or ADHD might mean sensory differences shaping hunger, routines, eating and body awareness. Autistic, ADHD and AuDHD people can also find that disordered patterns help to regulate overwhelming emotions, or make it easier to mask or fit in.

Eating disorder therapy for autism, ADHD and AuDHD

Support for eating disorders often expects you to look, sound and behave a certain way: what you say, how distressed you seem, how you engage in sessions. If you don’t, for example because you’re autistic, you can end up not being taken seriously or being referred between ADHD and autism services and eating disorder services, when what you need is both together.

Eating disorder therapy often needs adapting to fit a neurodivergent brain. Things like sensory issues, or struggling to notice when you’re hungry, needing routine or struggling to plan, and overwhelming emotions (or the opposite: trouble identifying, understanding, describing, and processing feelings) all shape your relationship with food. These need to be worked with as part of therapy. They’re not about you being resistant, demand avoidant or unmotivated.

Whether or not you have a formal diagnosis, I adapt therapy around how you think, process information and experience the world. This includes:

• your communication style
• what you like, and what’s important to you, around food and more generally
• whether it’s easier to communicate while doing something, such as crafting
• how eye contact feels for you
• whether fidgeting or holding objects helps you to talk
• whether you need more time to process information or take breaks

A specialist approach adapted to you

I hold specialist practitioner training in eating disorders through the National Centre for Eating Disorders, as well as specific training in eating disorders in autistic people. I also work with neurodivergent clients who struggle with food, eating and body image.

My work is grounded in evidence-based approaches, and we work on the food and the feelings. We might use CBT tools to unpick unhelpful thought patterns, DBT skills to handle overwhelming emotions, or gentle exposure work if anxiety and avoidance are keeping things stuck. Sometimes I make use of other ways of working, like drawing, grounding using objects around us, or body-based work like tapping (EFT). If something we try doesn’t feel like a good fit, we’ll look at why and change it.

Working with the feelings and the eating at the same time

How you feel affects what you eat, and what you eat affects how you feel, so eating disorder therapy works best when it treats both together, not one after the other. I work with the food and the feelings at the same time. On the feelings side, this includes working with self-criticism, finding ways to cope with overwhelming emotions, and building self-esteem, so food takes up less space in your head, and you’ve got more energy for the rest of your life. On the eating side, we look at what normal eating looks like for you, build up more consistent and flexible eating patterns, work on food noise, and widen the range of foods you feel comfortable eating.

Eating disorders and difficulties I support

I work with a range of eating and food-related difficulties, including:

Overeating/bingeing

Bingeing is eating a large amount of food in a short space of time, often feeling out of control while it’s happening. It might feel like you can’t stop, or you’re outside your body.
It’s often a way to cope, eating to numb difficult feelings or thoughts, but can lead to a lot of guilt and feelings of shame. For some people, bingeing might involve eating a lot of the same food at once, or in a way that is unusual to them.

Bulimia

Bulimia involves cycles of bingeing followed by purging. This can be through vomiting, laxatives, excessive exercise or other ways of trying to get rid of what’s been eaten as soon as possible. It can feel like a way to stay in control, and it can give space or numbness from intense feelings.

Restrictive Eating

Restrictive eating means limiting how much or what you eat, sometimes through strict rules like never eating certain foods. There is often an intense fear of weight gain. It doesn’t always start with wanting to be thin, it can be about control, fear, or food no longer feeling safe. It can look different for neurodivergent individuals.

Anorexia

Anorexia often involves an intense fear of gaining weight and a very restricted food intake. Often, someone with anorexia is underweight, but not always. You can have anorexia but not be underweight, known as atypical anorexia.
Atypical anorexia is not necessarily a “mild” form, as it still has a huge impact on someone’s life. Anorexia can have different underlying causes in people who are neurodivergent.

ARFID

ARFID, or Avoidant Restrictive Food Intake Disorder involves avoiding foods because of sensory sensitivities, fear of choking or vomiting, or a general lack of interest in food. It’s not simply fussy eating, and it isn’t always with the intention of losing weight.
Often, people haven’t heard of ARFID and it can be hard to explain it to other people.

Complex patterns or eating disorders that change over time

Not everyone’s eating fits neatly into one category. You might restrict at times and lose control at others, or have experienced anorexia at one time, and then bulimia or binge eating later in life.
You might also look recovered to others or have what people consider normal behaviours around food, but still struggle with the feelings.

What does eating disorder therapy look like?

We usually plan to work together for three months or more, reviewing progress after the assessment phase.

Throughout therapy

Progress tracking
At times I use an app or food diary to help set goals, notice what’s going well and learn from challenges or slip-ups. We will also take time to notice and celebrate when things feel good.

Between sessions
We’ll agree a plan for what to work on between sessions, so you can keep moving forward outside the room.

Nutritional support
We’ll work towards eating in a way that works for you. Where it’s helpful, I work alongside a nutritionist or dietitian.

Working together
Some of the work is structured and led by me, but I’m here to support you to make your own choices and trust your judgement. We’ll make decisions about what we do in therapy together, you have choices.

Questions you might have

We can look at what was difficult about therapy before and what made it feel unmanageable. Therapy will still feel difficult at times, but we will work through it together and I will check in with you regularly about what is working and what isn’t.

Starting therapy

I offer a no cost 30 minute initial consultation by telephone, Zoom or face to face. It’s a chance to talk about what’s going on and work out together whether I’m the right fit.