If you're reading this, part of you is probably wondering
whether therapy could actually help. Maybe you've been
struggling with food and your body for a while now. Maybe
someone you love is. Either way, you deserve to know what
this process actually looks like, not the vague, clinical
version, but the real one.
I'm Janelle, a Registered Psychotherapist in Ottawa
specializing in eating disorder treatment. Here's an honest
look at how therapy works, what the research says, and why
this work matters to me far beyond the clinical.
First, Let's Clear Up Some Myths
Eating disorders are among the most misunderstood mental
health conditions. Before we talk about treatment, it's
worth addressing what eating disorders are not.
Eating disorders don't only affect young, thin, white women.
This is probably the most harmful myth out there, and it
has real consequences. It stops people from seeking help
because they don't "look like" someone with an eating
disorder. The reality is that eating disorders affect people
of all ages, genders, body sizes, and backgrounds. The
reason this myth persists has more to do with who has
historically been included in research than with biological
reality.
Eating disorders are not a choice, a phase, or a lifestyle.
They are serious mental health conditions, and they are
treatable. Early intervention makes a significant difference
in both the duration and severity of the illness. If you've
been waiting until things get "bad enough" to reach out,
I want to gently tell you: now is the right time.
Where Treatment Actually Starts: The Relationship
Here's something that might surprise you: eating disorder
therapy doesn't start with meal plans or food rules. It
starts with a relationship.
Before we do any structured treatment work, the first
sessions are about getting to know you, your history,
your life, and your eating disorder specifically. What
function does it serve? What keeps it going? What does
your life look like when the eating disorder is loudest?
This matters because eating disorders are not just about
food. They are deeply connected to identity, control,
emotions, and self-worth. A therapist who skips straight
to the protocol without understanding you first will miss
the most important part.
The Approach I Use: CBT-E
I use Enhanced Cognitive Behavioural Therapy, or CBT-E.
It is the gold standard evidence-based treatment for eating
disorders and works across anorexia nervosa, bulimia
nervosa, and binge eating disorder.
CBT-E typically runs about 20 sessions and works by helping
you understand the thoughts, feelings, and patterns that
maintain the eating disorder, and gradually loosen their
grip. Research shows that approximately two thirds of people
who complete CBT-E treatment achieve full remission. Those
are meaningful numbers.
What makes CBT-E different from general therapy is that it
is specifically designed for eating disorders. It addresses
not just the behaviours around food, but the deeper
mechanisms that keep the eating disorder alive such as perfectionism, low self-esteem, and difficulty
tolerating emotions.
The Shift I See in Clients
One of the most powerful moments in eating disorder
recovery is when someone starts to see the eating disorder
as separate from themselves.
So much of the suffering comes from feeling like the eating
disorder is just who you are, that the voice telling you
what to eat, how much, and what your body should look like
is your own voice. It isn't.
When clients start to externalize the eating disorder, to
see it as something that happened to them rather than
something they are, everything starts to shift. They can
examine it, challenge it, and eventually choose differently.
That moment is one of the most meaningful things I get to
witness in this work.
You Don't Have to Do This Alone
Eating disorder treatment works best as a team effort.
I collaborate with dietitians and physicians when
appropriate, always with your consent and with your
confidentiality fully protected. Each member of the team
has a specific role, and together we can offer support
that no single person can provide alone.
If you are already working with a doctor or dietitian,
that's a great foundation. If you're not, I can help
you think through what additional support might look like.
Is Therapy Right for You?
You don't need a formal diagnosis to reach out. If food
and your body are taking up more mental space than you'd
like, if mealtimes feel like a battleground, if you find
yourself caught in cycles you can't break, if your
relationship with your body is causing you real pain,
that is enough of a reason to talk.
I offer a free 15-minute consultation before we begin.
No pressure, no commitment, just a conversation to see
if working together feels right.
I work in English and French, in person at my Ottawa
office and virtually across Ontario.
If you're ready to take that first step, I'd love to
hear from you.
Janelle Massicotte
Contact Me
