Lying and Eating Disorder Treatment

I got a sad text last night from one of my “recovered” anorexic patients. She has maintained a healthy weight for years, but during a family meeting I had asked what she had for breakfast and she lied. I did not know this at the time but her parents found out and were concerned. She immediately sent me a text letting me know what happened, and hopefully will come in today to further discuss the matter. She felt “ashamed, angry, guilty, lonely and sad” over the fact she had lied to me and her parents over something seemingly minor.


Many people ask me how I specialize in treating eating disorder patients when there’s usually a lot of lying and denial –these behaviors make the work frustrating and difficult at times. The majority of my patients almost always acknowledge that they lied or manipulated me or loved ones during their treatment. I have to admit that this can be frustrating, but over the years I have learned to combat it. One way is including loved ones in the treatment process. I invite parents in to every session, or at least call them during sessions to make sure they hear my first hand recommendations. I also model the behaviors I want the clients to engage in, and expect the patient to eat with me foods on their meal plan.

Despite all these actions, the lying still happens, and when it is discovered I encourage the patient to see it as a warning bell that something is bothering them. The predicaments these individuals face probably have little to do with the thing they are lying about (i.e. not eating a correct breakfast), but are actually masking a deeper internal problem. I encourage the patient to tell themselves, “Wow something must really be bothering me to elicit this old behavior”. Whether in the beginning of final stages of recovery, all patients must be aware of the impact lying has on their emotional and mental well being.

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