Are Eating Disorders Linked to Control?

Eating Disorder Support

Understanding the Psychological Factors

Eating disorders are often described as being “about control”. While this idea is common, it is also over-simplified. For many people, eating difficulties are less about wanting control and more about trying to cope with feelings that feel unmanageable.

This article explores how control can feature in eating disorders, why it develops, and how understanding this can shape more effective support.

Control as a coping response, not a personality trait

People do not usually develop eating disorders because they want to control everything. More often, restrictive or repetitive eating behaviours emerge as a response to:

• Emotional overwhelm

• Chronic stress or uncertainty

• Feeling unsafe or ungrounded

• Difficulty regulating emotions

  
  

Food and eating can become something concrete and predictable when other areas of life feel unpredictable.

How control can show up in different eating difficulties

Control does not look the same across eating disorders. The behaviours may differ, but the underlying function is often similar.

Restrictive eating and predictability

In restrictive eating patterns, rigid rules around food or exercise can create a sense of structure. This structure may temporarily reduce anxiety or provide a feeling of stability.

Over time, however, the rules tend to narrow, and flexibility decreases, increasing distress rather than reducing it.

Binge–purge cycles and emotional regulation

For some people, cycles of binge eating and compensatory behaviours reflect swings between feeling overwhelmed and trying to “reset” or undo that distress.

The issue is not a lack of self-control, but rather difficulty tolerating intense emotions without food-related behaviours.

Binge eating and loss of control

In binge eating disorder, people often describe feeling out of control during eating episodes. Food may be used to numb or distract from emotional pain.

The sense of control is not gained through eating, but briefly suspended, which is why shame and distress often follow.

Health-focused restriction and certainty

In patterns sometimes described as orthorexia, control may centre on health, purity, or safety. Strict food rules can create a sense of certainty and moral clarity.

This can gradually lead to rigidity, anxiety, and social withdrawal.

Psychological factors commonly linked to control

Control-related eating patterns often sit alongside other psychological experiences.

Perfectionism and high internal standards

Many people with eating difficulties hold themselves to very high standards. Food and eating can become one area where success feels measurable or attainable.

This does not mean perfectionism causes eating disorders, but it can make rigid patterns harder to loosen.

Emotional regulation differences

Some individuals experience emotions more intensely or find them harder to process. Eating behaviours may develop as a way to manage or dampen emotional states.

This is particularly relevant for people who are neurodivergent or who have experienced chronic stress.

Trauma and safety

For some, eating behaviours are linked to a need for safety or grounding following traumatic experiences. Control around food may provide a sense of protection when the body or world feels unsafe.

Trauma-informed care is important where this is relevant.

Why focusing only on “control” can be unhelpful

Framing eating disorders as being about control alone can:

• Increase shame

• Oversimplify complex experiences

• Miss the emotional function of behaviours

  
  

Effective support looks beyond behaviour and explores what the behaviour is doing for the person.

How treatment addresses these patterns

Treatment does not aim to “take control away”. Instead, it helps people develop safer, more flexible ways of coping.

Support may include:

• Psychological therapy to explore beliefs, emotions, and coping strategies

• Work on emotional regulation and distress tolerance

• Dietetic support to reduce fear and rigidity around food

• Trauma-informed approaches where relevant

  
  

Change is gradual and collaborative.

When it may be helpful to seek support

If eating behaviours feel rigid, distressing, or increasingly necessary to cope with emotions or stress, professional support can help clarify what is happening and identify appropriate next steps.

You do not need to fully understand the reasons behind behaviours before seeking help.

How we can help

At The Eating Disorders Clinic, we take an assessment-led, psychologically informed approach to eating disorders. We focus on understanding each person’s experience, rather than applying assumptions about control or motivation.

Support is individualised, paced carefully, and reviewed over time.

A gentle next step

If you would like to talk through concerns or explore whether support might be helpful, you are welcome to book a free initial call.

You can also review our website to understand how our service works before making any decisions.

Author: Stefanos Pagonidis – Clinical Director, Lead Dietitian at the Eating Disorders Clinic

References:

• Fairburn, C. G. (2008). Cognitive Behaviour Therapy and Eating Disorders. Guilford Press.

• Treasure, J., Claudino, A. M., & Zucker, N. (2010). Eating disorders. The Lancet, 375(9714), 583-593.

• American Psychological Association (APA). (2020). Eating disorders and control. Available at: APA Website