As a therapist specializing in the treatment of eating disorders, posing the question, "Who are you without an eating disorder?" often evokes feelings of unease and uncertainty for my patients. The eating disorder may have woven itself so profoundly into their sense of self that it blurs the boundaries between the individual and the illness.

The inclination to over-identify with the illness is understandable, especially for those whose eating disorders developed during their formative years and persisted for decades. The eating disorder may have initially emerged as a response to emotional pain, acting as a mechanism to soothe, numb, express, or communicate that pain. To take that coping mechanism away may be akin to taking away a security blanket or a life raft.

Early psychodynamic theorists identified eating disorders as disorders of the self, where symptoms manifested as a response to inner turmoil.1 The over-identification with an eating disorder can make it challenging to discern the person from the illness. Particularly in cases like anorexia nervosa, where behaviors align........

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