The Keep Smiling Podcast

#98 Addressing the Psychological Roots of Eating Disorders & Overcoming Body Image Challenges | Thomas Midgley


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Today, I'm joined by Thomas, a Behavioural and Cognitive and Compassion focused Psychotherapist as well as a Highly Specialised Eating Disorders Dietitian.  

For over 20 years Thomas has been working in the NHS and/or Private sector with both adolescents and adults in the fields of Eating Disorders, Personality Disorder, body dysmorphic disorder and Complex Trauma. 

We explore how long-term, sustainable recovery requires looking beyond just the physical symptoms like weight gain and BMI restoration. True recovery involves addressing the underlying psychological factors—something that often gets overlooked. Together, we’ll discuss the importance of understanding the embedded beliefs, thoughts, emotions, and triggers that need to be considered for a more holistic approach to recovery.

Tom offers his insights into the complexity of body image, explaining how it's shaped by a web of interrelated factors. For many, body image is dominated by an inescapable inner critic—constantly reinforced by toxic cultural messages that equate self-worth with appearance. These external pressures only magnify the struggle. So, we discuss the importance of untangling these deeply ingrained thought patterns and gaining clarity on the underlying motives driving them. Tom stresses the need for a personalised approach—working with patients in a way that aligns with their unique values and beliefs. This tailored strategy not only helps them gain insight into their thought processes but also equips them with the skills and resources needed to cope more effectively and sustain long-term recovery.

We examine the characteristics often associated with eating disorders—such as perfectionism, unrelenting standards, and a drive for achievement. These traits can exacerbate disordered eating tendencies in the pursuit of validation and self-worth.

But as Tom points out, the goal isn't to eliminate these traits; it’s to leverage them in a healthier way. These same traits, when redirected, can fuel recovery. This is something I relate to personally - my determination and stubbornness took me to a dark place with my anorexia, but they were also the very traits that powered my recovery. We talk about how to channel that energy into something positive and constructive, transforming what once fueled the disorder into a source of strength.

thebodyimagetreatmentclinic.co.uk 



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