Therapist identifies coercive control as root cause of patient’s disordered eating
A case study published in an opinion column reveals how cognitive behavioural therapy and cognitive processing therapy helped a patient recognise a pattern of abuse and begin recovery
A therapist writing in The Guardian Opinion column has detailed how a patient, referred to as Ali, sought treatment for disordered eating only to discover the behaviour was a symptom of coercive control exerted by her ex-partner over a three-year period. The article, authored by Ahona Guha, outlines how dietary restrictions and body monitoring were used as tools of manipulation before the underlying abuse was identified.
Ali, described as a young and diffident woman, initially presented with cycles of restricted eating followed by excessive exercise. Treatment utilised cognitive behavioural therapy for eating disorders to address her “food rules,” such as the belief that carbohydrates were harmful. During this process, it became apparent that her assumptions regarding shape and weight coincided with the start of her relationship with a partner described as a “gym junkie.”
The ex-partner, identified in the text as Ian, imposed strict controls on Ali’s diet and appearance. He reportedly became angry if she consumed carbs and enforced a joint meal plan designed to help her “shred and look hot” when they were in public. These dietary controls were part of a broader pattern that included monitoring her bank transactions, dictating her clothing choices, and isolating her from friends through jealousy and arguments.
Sexual coercion was also employed, with Ian framing Ali’s reluctance to engage in certain acts as a failure of partnership. The therapist noted that Ali’s eating habits stabilised once she recognised this pattern of coercive control. Unlike physical violence, coercive control often manifests as repeated subtle behaviours inflicted with the victim’s seeming agreement, making it difficult to detect.
Recovery involved cognitive processing therapy techniques to address post-traumatic stress and distorted beliefs. Ali worked to separate her emotions from reality, challenging the idea that she was “not enough” and rebuilding her confidence in social settings. The article notes that while recovery was not linear, Ali was able to stop blaming herself and reconnect with supportive friends.
Support resources for those experiencing similar issues are listed in the article, including the Butterfly Foundation in Australia, Beat in the UK, and ANAD in the US. The account remains a single therapist’s perspective and case study rather than a peer-reviewed clinical trial.
