DBT

Dialectical Behaviour Therapy (DBT) for Eating Disorders

An evidence-based approach that helps individuals understand emotions, reduce distress, and support lasting recovery.

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DBT EXPLAINED

What Is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) is a psychological intervention designed to help people understand, tolerate, and manage difficult emotions. It combines cognitive-behavioural strategies with mindfulness and acceptance-based techniques.


DBT has been specifically adapted for eating disorders across the spectrum, including restrictive presentations such as anorexia nervosa and binge–purge presentations such as bulimia nervosa and binge eating disorder. These adaptations focus on the emotional processes and behavioural patterns that maintain eating difficulties.

1.25M

people living with an eating disorder

At The London Centre, we offer a DBT-informed approach.

This means we bring DBT principles and skills into one-to-one therapy, without delivering the full-model DBT programme (which includes weekly skills groups and between-session crisis support).

46%

of Adults feel unhappy about their appearance

CORE PRINCIPLES

DBT and RO-DBT: Understanding Emotional Styles in Eating disorders

Two patterns of emotional experience are commonly seen in eating disorders, and DBT has been adapted to support both:

1. Standard DBT – for emotional dysregulation

Emotional dysregulation involves experiencing emotions intensely and finding them difficult to manage. This pattern is often seen in binge–purge presentations (such as bulimia nervosa), emotional eating, and in individuals with trauma histories. DBT helps individuals understand their emotions, tolerate distress, and find alternative coping strategies to behaviours such as bingeing or purging

2. RO-DBT – for emotional overcontrol

Radically Open DBT (RO-DBT) is designed for people who struggle with emotional overcontrol – for example, those who appear calm or composed externally but experience internal tension, perfectionism, or rigidity. This emotional style is common in restrictive eating disorders such as anorexia nervosa. RO-DBT supports individuals to increase openness, flexibility, emotional expression, and connection with others.

At The London Centre, clinicians will draw from DBT or RO-DBT principles depending on the emotional patterns underpinning a client’s difficulties.

How We Support you

How DBT-Informed Therapy Supports Recovery from Eating Disorders

Many eating disorder behaviours – restricting, bingeing, purging, fasting, or rigid routines – function as attempts to manage overwhelming or uncomfortable emotions. These skills support progress across both restrictive and binge–purge presentations.

DBT helps individuals:

  • Understand their emotional triggers
  • Recognise the thoughts and sensations that lead to eating disorder behaviours
  • Tolerate distress without relying on unhelpful coping strategies
  • Respond differently to difficult situations
  • Develop a more workable, compassionate relationship with emotions

The Core Skills of DBT

Our DBT-informed approach integrates the four main DBT skills into one-to-one therapy:

Mindfulness and Emotional Awareness

Mindfulness helps individuals notice emotions, thoughts, and urges without judgment. This awareness supports more intentional choices around food, behaviour, and daily life.

These skills help individuals understand their emotions and cope with distress safely, rather than automatically turning to restrictive or binge–purge behaviours.

Distress Tolerance and Emotional Regulation

Interpersonal Effectiveness

This module supports individuals to set boundaries, communicate needs, and navigate relationships more confidently – often an important part of recovery.

The benefits

Benefits of DBT for Eating Disorders

A DBT-informed approach can help individuals:

  • Understand emotions and tolerate distress
  • Reduce bingeing, purging, or rigid control around food
  • Interrupt unhelpful behavioural cycles
  • Increase awareness of emotional triggers and responses
  • Develop new tools for coping with everyday challenges
  • Improve communication and connection with others
  • Receive a therapy model tailored entirely to one-to-one work
COLLABORATIVE Care

What to Expect During DBT-Informed Therapy

At The London Centre, DBT-informed therapy is delivered exclusively in structured one-to-one sessions. Therapy is collaborative and paced to feel supportive and manageable. Each session explores patterns that have emerged throughout the week and builds on relevant DBT or RO-DBT skills.

DBT can be a standalone therapeutic approach, or it can sit alongside:

  • Dietetics
  • Psychiatry
  • Occupational Therapy
  • Family Therapy

These areas provide additional support with nutrition, medical safety, day-to-day functioning, and family dynamics.

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DBT PROGRAMMES

Full-Model DBT vs DBT-Informed Therapy

To ensure accuracy and clarity, we distinguish between our DBT-informed approach and the full-model DBT programme:

DBT-informed therapy (what we offer):

  • One-to-one therapy only
  • Integration of DBT or RO-DBT skills
  • Adapted for eating disorder presentations
  • Compassion-Focused Therapy (CFT)
  • Suitable for clients who do not require full-programme DBT

Full-model, adherent DBT (delivered by partner services):

  • Weekly DBT skills-based groups
  • Weekly one-to-one DBT sessions
  • Between-session phone coaching or crisis support
  • A high-intensity, highly structured treatment model

How DBT Fits into Treatment at The London Centre

DBT-informed therapy is one of several evidence-based approaches offered within our multidisciplinary team. It is personalised to each person’s needs, drawing on either DBT or RO-DBT principles depending on emotional patterns, coping styles, and the nature of the eating disorder.

Your clinician will explore whether a DBT-informed pathway, an alternative psychological therapy, or a combination of psychological therapy with dietetic, psychiatric, occupational, or family support is the most appropriate next step.

Is DBT Right for Me?

DBT-informed therapy may be helpful if you:

  • Find emotions overwhelming or difficult to manage
  • Struggle with emotional avoidance or overcontrol
  • Use eating disorder behaviours as a way to cope with distress
  • Experience binge–purge cycles or rigid rules around food
  • Feel stuck in patterns of shame, avoidance, or perfectionism
  • Want structured support for understanding and managing your emotions
Your clinician will always guide you towards the approach that best fits your emotional needs and stage of recovery.
Start your journey

Take the First Step
Towards Recovery

Reaching out can feel daunting, but it is a meaningful first step towards positive change. Our clinicians offer compassionate, specialist support to help you understand your emotions, your eating disorder, and the skills that will support recovery.

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FAQs

FAQs About DBT for Eating Disorders

DBT targets the emotional patterns and coping mechanisms that often drive restrictive or binge–purge behaviours. It provides practical skills for understanding emotions and managing distress.

Yes. Standard DBT is often helpful for binge–purge presentations involving emotional dysregulation, while RO-DBT is well-suited to restrictive presentations characterised by emotional overcontrol.

No. We offer DBT-informed one-to-one therapy. If you require full-model DBT, including skills groups and crisis coaching, we can refer you to a trusted partner service.

Length varies depending on individual needs. Many clients attend weekly sessions for several months to learn and practise DBT or RO-DBT skills.

Yes. DBT-informed therapy can be offered alongside dietetic support, psychiatry, occupational therapy, and family therapy. 

Yes. We offer DBT-informed sessions both in person and virtually.