Diet culture is everywhere, woven into nearly every aspect of our lives. Even after more than 15 years in practice as an LCSW, my training in addressing body image struggles, disordered eating, and eating disorders isn’t as strong as it could be – despite these issues arising regularly in my practice.
These topics permeate every part of a person’s life, including our own as therapists. Yet, often, they go undiscussed during intake and treatment. We all have relationships with food and our bodies. Many of us therapists know the personal struggle of tying one’s worth to one’s weight and appearance. So why isn’t this issue more openly addressed in our training and work as therapists? It’s a fundamental part of a person’s identity and daily experience, yet it often gets overlooked or minimized.
This is why I was drawn to our recent community event, Diet Culture: Assessment, Treatment, and Countertransference. I wanted to explore how diet culture and our personal experiences shape our professional practice and the therapeutic space. Dr. Kate Sheridan‘s presentation was impactful. It significantly enhanced my understanding of how to conceptualize and navigate conversations about disordered eating and eating disorders in a way that feels more client-centered and strengths-based. It was also an opportunity to examine how traditional mental health training and terminology around eating disorders and disordered eating are steeped in racism and shame. Her approach challenged the pathologizing tendencies of traditional medical frameworks and invited a more inclusive, compassionate perspective that also includes therapists being mindful of their countertransference or personal feelings about food and weight.
Often, diet culture is so normalized we don’t even recognize it, even as therapists. It shapes how we think about ourselves when we look in the mirror, put on a pair of jeans, or compare our bodies to what we see on our screens or among our friends. It can influence sexual identity and how we relate to our romantic partners. These pressures follow us through nearly every life stage, from childhood to the self-conscious years of puberty and adolescence and on to the adult years, where parents often confront terms like ‘post-baby body’ and ‘dad bod.’
Even as people age, they are bombarded with messages about fighting the natural changes in their bodies. Each of these experiences contributes significantly to people’s mental unwellness. They also seep into our beliefs and biases as therapists, underscoring the need to address these issues more intentionally in our clinical work. Recognizing the far-reaching impact of diet culture is key to fostering deeper, more compassionate conversations in therapy for our clients who struggle with eating disorders, disordered eating, and body image.
During our small group discussion at the community event, we reviewed a case vignette on a 350-pound woman who was bedridden and needed help attending to many of her daily needs. As I reflected on this case, I noticed the different parts of me reacting in various ways, some of which were shaming, fatphobic, and unsympathetic. A part of me also wanted to intellectualize the information about this woman to keep it at a safe distance. This internal response highlighted my discomfort, rooted more in my own humanness and the ways I’ve been shaped by diet culture rather than in the struggles of the client herself. I can’t help but think that if this were my client, I could be at risk of unintentionally perpetuating harm through subtle or unconscious messaging.
Fortunately, Dr. Sheridan addressed how therapists can unintentionally perpetuate diet culture through subtle messages during her presentation. Comments or jokes about food, weight, or body size, even those made in passing, can reinforce harmful narratives. Assuming that clients in larger bodies want to lose weight or failing to ask how they feel about their bodies can unintentionally lead to feelings of shame and alienation. Perpetuating the belief that weight is controllable or that being in a larger body is a moral failing can also cause harm. These micro-messages, whether explicit or implicit, can undermine a client’s sense of safety and trust in the therapeutic relationship. Recognizing and actively challenging these biases in our work is essential for fostering a space where clients feel fully seen and accepted, regardless of their body size or shape.
This event was a powerful reminder of the importance of leaning into exploring our humanness as therapists when addressing the pervasive impact of diet culture. Just as our clients’ relationships with food and their bodies permeate every aspect of their lives, so too do our own beliefs and biases shape the therapeutic space. Recognizing and addressing these influences is not about achieving perfection but about fostering greater awareness and compassion—for ourselves and those we serve. By engaging in our own therapy, supportive consultation, or reflective practice, we can better explore countertransference and ensure we are creating a space where all clients feel seen, accepted, and empowered. Only through this ongoing work can we move beyond traditional frameworks steeped in shame and bias to build a more inclusive and client-centered approach to care.
