Is My Work the Right Fit If You’ve Had Anorexia or Inpatient Treatment?

Understanding suitability, safety, and where private therapy can help, and where it can’t.

If you’re reading this, you may be wondering whether my approach to therapy is appropriate for you, particularly if you have experienced anorexia, significant restriction, or previous inpatient or day-patient treatment.

This is an important question, and one I welcome.

Eating disorder recovery is not one-size-fits-all. The type, timing, and level of support matters, not just for progress, but for safety.

A clear starting point

I work with adults experiencing eating distress, including restrictive eating patterns, binge–restrict cycles, and the psychological and nervous-system factors that maintain them.

I do not provide:

• crisis care

• inpatient or day-patient treatment

• medical stabilisation

• emergency eating disorder management

  
  

My work is outpatient and is most appropriate for people who are medically stable enough to engage in psychological therapy.

This boundary is not about motivation, effort, or deservingness. It is about what can be held safely and ethically in private practice.

The complicated reality of eating disorder services

It’s important to name something many people struggle to say out loud:

Eating disorder services can be both lifesaving and traumatising.

For some people, inpatient or intensive treatment provides essential protection during a critical period. For others, the experience can feel:

• coercive or dehumanising

• overly focused on weight, compliance, or risk metrics

• invalidating of neurodivergence, identity, or trauma history

• experienced as a loss of autonomy or bodily agency

  
  

These experiences matter. They often leave a psychological and nervous-system imprint that isn’t resolved simply by discharge or weight restoration.

Acknowledging this does not mean those services were unnecessary. It means that survival and recovery are not the same thing, and that different kinds of support are needed at different stages.

BMI, medical risk, and the limits of blunt tools

BMI is an imperfect and often harmful measure. It does not account for:

• individual physiology

• neurodivergent bodies

• gender and cultural differences

• metabolic adaptation

• the psychological cost of weight-centred care

  
  

Many people have been injured, physically and psychologically, by an over-reliance on BMI as a proxy for readiness or worth.

At the same time, medical risk is real.

Severe under-nutrition affects:

• cognition and decision-making

• emotional regulation

• trauma-processing capacity

• physical safety

  
  

This creates a necessary tension:

We can critique BMI and still acknowledge when a body is not safe enough for certain kinds of psychological work.

Both things can be true.

Harm reduction — and where a line has to be drawn

I work from a harm-reduction, nervous-system-aware framework. This means:

• prioritising safety over perfection

• reducing shame and moral judgement

• supporting people where they are, not where they “should” be

• recognising that recovery is rarely linear

  
  

However, harm reduction does not mean that anything goes.

In private outpatient therapy, there is a line where the level of medical or nutritional risk means that what I can safely offer is limited.

That line exists because:

• trauma-focused therapy requires a nourished brain

• EMDR and deeper processing can increase risk when the body is unsafe

• private therapy does not have the containment of multidisciplinary services

  
  

Holding this boundary is not abandonment. It is clinical responsibility.

When my approach is not the right fit

My work is not appropriate if:

• you are currently medically unstable

• there is ongoing rapid weight loss

• eating is extremely limited or absent

• physical health is unsafe or deteriorating

• inpatient or day-patient care is being actively recommended

  
  

In these situations, specialist eating disorder services are the right place to start, even if previous experiences with them were difficult or harmful.

Private therapy cannot safely replace that level of care.

When my work often is a good fit

Many people I work with:

• have a history of anorexia or severe restriction

• have been inpatient or in intensive treatment in the past

• are no longer acutely unwell

• but feel stuck, fearful, or lost after discharge

  
  

For these individuals, therapy often focuses on:

• the psychological and nervous-system residue of the illness

• the trauma of eating disorder treatment itself

• fear of weight change or loss of control

• rigidity, perfectionism, and moralised beliefs about food

• identity beyond the eating disorder

• neurodivergence, sensory needs, and autonomy

  
  

This is often the phase where the question becomes:

“I survived — but how do I actually live?”

That is where private therapy can be most helpful.

How suitability is explored

If you’re unsure whether my approach is appropriate for you, this is explored through a paid clarity call, which includes a careful suitability conversation.

We look at:

• current eating patterns and stability

• physical health and medical oversight

• past treatment experiences

• what you’re hoping therapy will address now

  
  

If I feel a different level or type of support would be safer, I will say so, clearly and respectfully, and, where possible, help you think about next steps.

If I say not yet, it is not a judgement of your worth or readiness. It is a commitment to your safety.

A clear and compassionate bottom line

It is possible — and necessary — to hold all of the following as true:

• eating disorder services can be harmful and lifesaving

• BMI is flawed and medical risk matters

• harm reduction is essential and boundaries are required

• someone can be deserving of care and need a different level of support first

  
  

My responsibility is to work ethically, safely, and transparently, even when that means saying not yet.

About the author

Becky Grace is a BABCP-accredited CBT and EMDR therapist specialising in eating disorders, neurodiversity, OCD, and complex trauma. She works with adults experiencing eating distress and recovery-stage difficulties using a paced, nervous-system-aware approach, and offers in-person therapy in Norwich alongside UK and international online therapy.

Booking therapy: a clear 2-step process

If you’re considering therapy, working together begins with a structured process.

Step 1: Paid clarity call (including suitability assessment) A focused therapeutic consultation to explore what you’re seeking support for and whether my approach is appropriate and safe at this stage.

Step 2: Therapy begins If we decide to proceed, we agree a therapy plan. This may involve weekly sessions, structured therapy blocks, or focused intensives, depending on your needs and circumstances.

You can view availability and book via my client portal here:👉 https://clientportal.uk.zandahealth.com/clientportal/beckygracetherapy

Further information about fees, location, and ways of working is available at:👉 www.beckygracetherapy.co.uk