Coming Home to Your Body: What Does Interoception Have to do with Eating Disorder Recovery and High Achievers?
When people think about eating disorders, they often picture food: restricting it, bingeing on it, compensating for it. But underneath the food behaviors, many people with eating disorders share something less visible. They've lost touch with the signals coming from inside their own bodies.
Hunger, fullness, fatigue, anxiety, sadness, even the need to rest. These internal cues are often muted, confusing, or frightening. In their place, decisions get handed over to external sources: a calorie count, a meal plan someone found online, the number on a scale, the time on a clock, a rigid workout routine, what someone else is eating and beyond like achievements, career, or overall productivity.
This post explores that disconnection, why it happens, and why one of the most important goals of eating disorder recovery (especially for those high achievers) is slowing down and learning to listen to and trust your body again.
What is Interoception?
Interoception is your ability to sense and make sense of what's happening inside your body. It's sometimes called the "eighth sense." It includes noticing your heartbeat, breathing, temperature, muscle tension, hunger and fullness, the need to use the bathroom, and all subtle and not so subtle physical sensations that come with emotions.
Interoception is how your body communicates its needs. A growling stomach says "feed me." A heavy, tired feeling says "rest." A tight chest and racing heart might say "something feels unsafe." It's a gut feeling saying “something isn’t sitting right about this situation”. When interoception works well, these signals guide you toward taking care of yourself, often without much conscious thought.
Interoceptive awareness involves noticing a sensation, tolerating it, and interpreting it accurately. All which can be disrupted in eating disorders and reinforced in a society or culture that values productivity, discipline and quantifying work. For some, this gets reinforced in the family system, sports/team culture or career as well.
How Eating Disorders Disconnect You from your Body
Research has consistently found differences in interoception among people with anorexia, bulimia, binge eating disorder, and ARFID. Some people struggle to notice internal signals at all. Others notice them but can't tell what they mean: is this hunger, anxiety, boredom, or sadness? Some feel sensations intensely and experience them as threatening.
The eating disorder itself also deepens the disconnection. Restriction dulls hunger cues over time. Bingeing overrides fullness. Purging, compulsive exercise, and chronic dieting teach the body that its signals will be ignored or punished. Malnutrition affects the brain regions involved in processing body signals, which makes accurate interoception even harder.
As internal cues become less reliable, behavior becomes more externally driven. Instead of "Am I hungry?" the questions become:
How many calories or grams is this?
Did I earn this food today?
What time is it, and when am I "allowed" to eat?
What is everyone else ordering?
What did the scale say this morning?
How do my clothes fit, or how do I look in the mirror?
These external rules can feel clear and certain. But they leave no room for what your body actually needs, and they keep you living from the outside in.
Why External Rules Feel Safer
If external rules are so limiting, why do they hold such a strong grip? Often because the inside of the body doesn't feel like a safe place to be.
For many people, internal sensations are tied to distress. Hunger might trigger panic. Fullness might feel unbearable or bring up shame. Emotions like sadness, anger, or loneliness can show up as overwhelming physical sensations with no clear name. For people with a history of trauma, chronic stress, or sensory sensitivities, the body may have learned that tuning out is the safest option.
Eating disorder behaviors can serve as a way to manage or escape these experiences. Restriction can create a numbing effect. Bingeing can drown out difficult feelings. Rigid rules offer a sense of control and predictability when the internal world feels chaotic and uncomfortable. In this way, the eating disorder makes sense. It's a strategy for coping with sensations and emotions that feel too much to hold.
The problem is that the relief is short-lived, and the cost is high (even though sometimes the negative effects aren’t immediately visible). The more you rely on external control, the less practice you get at understanding, responding to, and respecting your body, and the scarier those internal signals become.
When Your Body Doesn't Feel like a Safe Place
For some people, disconnection from the body didn't start with the eating disorder. It started earlier, as a way to cope with a body that felt painful, unpredictable, criticized, or unsafe. Tuning out was protective. It helped them get through experiences that were too much to feel fully.
Some of the ways this happens:
Trauma. When the body has been the site of harm, whether through abuse, assault, medical procedures, or other overwhelming events, internal sensations can become reminders of danger. A racing heart or a tight stomach may feel like the trauma is happening again. Numbing, dissociating, or intellectualizing and finding external loci of control can become automatic ways to stay safe.
Chronic illness and chronic pain. When internal signals mostly mean pain, nausea, fatigue, or flare-ups, it makes sense to stop listening. Conditions that affect digestion can make hunger and fullness especially confusing. Being dismissed or disbelieved by providers can also teach people that their body's signals aren't trustworthy or don't matter. Individuals with chronic illnesses often feel a sense of betrayal by their body not functioning how they would hope and struggle to want to meet its needs.
Sports and athletics. Many athletes are trained to push through pain, override fatigue, and ignore hunger to make weight, perform, or meet expectations. Fueling may be dictated by schedules and numbers rather than need. In aesthetic, weight-class, and endurance sports, the body is often evaluated from the outside, and its worth becomes tied to how it looks or performs. Even in non-aesthetic/weight centered sports, athletes often get praised for their ability to grind and tolerate distress which gets internalized or taken to extremes. If they are seeing success in their sport while engaging in these behaviors or pushing through, it gets solidified even more.
Fatphobia and diet culture. Diet culture teaches people from a young age that hunger is something to resist, that certain foods are "good" or "bad," and that smaller bodies are more worthy. Fatphobia adds real harm: bullying, comments from family, weight-biased medical care, and being treated as less than because of body size. When your body is constantly framed as a problem to fix, overriding its signals in favor of external rules can seem like the "right" thing to do.
Racism, discrimination, and other forms of oppression. People who experience racism, homophobia, transphobia, ableism, or other forms of oppression often learn that their bodies are watched, judged, or unsafe in the world around them. Living in a state of chronic vigilance takes a toll on the nervous system and can make tuning out feel necessary. Beauty and body ideals rooted in whiteness and thinness can also send the message that one's natural body is wrong. For some, controlling the body becomes a way to seek safety, acceptance, or a sense of control in systems that offer little of it.
Body shame and stigma. Comments about appearance, comparison, and the changes of puberty can all teach someone that their body is something to be ashamed of. When the body feels like a source of judgment, disconnecting from it can feel like relief.
This creates an added layer that reinforces the eating disorder. The body already felt unsafe, so internal cues were muted for protection. The eating disorder then deepens that disconnection, and the further someone gets from their body, the more threatening its signals feel when they do break through. Over time, external rules become the only guide that feels trustworthy.
Reconnecting with the body is not about forcing yourself to feel everything at once. It's about gently creating enough safety, in therapy, in your relationships, and in your own nervous system, that it becomes possible to start listening again. For people with a trauma history, chronic illness, or an athletic background, working with a therapist who understands these experiences can make that process feel much more manageable.
Recovery from an Eating Disorder or High Achieving Burnout Means Rebuilding Interoceptive Awareness
One of the central goals of eating disorder recovery is to slowly rebuild the connection between you and your body. That means learning to notice internal sensations, get curious about them, and respond to them with care.
This doesn't happen all at once, and it often doesn't start with hunger and fullness. Early in recovery, structure from a meal plan and your treatment team is important, because hunger cues may not be reliable yet. Over time, as your body is nourished and your nervous system settles, those signals often return and become easier to read.
Building interoceptive awareness might look like:
Pausing a few times a day to notice your breath, temperature, or muscle tension
Rating hunger and fullness before and after meals, without judgment
Noticing where emotions show up in your body (tight throat, heavy chest, restless legs)
Practicing naming sensations with more specific words than "good" or "bad"
Using gentle movement, yoga, or body-based practices that focus on how something feels rather than how it looks or what it burns
The goal isn't to feel perfectly in tune with your body. It's to move from "I have no idea what I need" toward "I can notice something is happening and get curious about it."
Distress Tolerance: Learning to Stay with Discomfort
Noticing your body is only half of the work. The other half is being able to stay with what you notice, especially when it's uncomfortable.
In recovery, you'll face sensations that the eating disorder or a sense of accomplishment used to help you avoid: the fullness after a meal, the urge to compensate, the anxiety of eating without a rule to follow, the grief or anger that surfaces when the behaviors quiet down. Distress tolerance is the ability to experience these feelings without immediately acting to make them stop.
This is where real change happens. Each time you ride out an uncomfortable sensation without turning to a behavior, your nervous system learns something new: this feeling is uncomfortable, but it's not dangerous, and it will pass. Over time, the sensations become less threatening, and you gain confidence that you can handle them.
Skills that support distress tolerance include:
Grounding techniques that bring you back to the present moment
Slow, paced breathing to calm the nervous system
Urge surfing, or noticing an urge rise, peak, and fall like a wave
Self-compassionate self-talk ("This is hard, and I'm doing it anyway")
Reaching out to a support person instead of handling it alone
The aim is not to never feel distress. It's to widen your window of tolerance so that discomfort doesn't automatically send you back to the eating disorder.
From Awareness to Embodiment and Self-Trust
As interoceptive awareness and distress tolerance grow together, something powerful begins to happen: embodiment. Embodiment means living inside your body rather than observing, judging, or controlling it from the outside. It's experiencing your body as a place you inhabit, not a project to manage.
With embodiment comes trust. When you can notice your hunger and respond to it, the scale and the rules start to matter less. When you can feel sadness and know you'll survive it, food no longer has to do the job of numbing it. Slowly, decisions shift from "What am I allowed to do?" to "What do I need right now?"
This trust extends beyond food. Many people in recovery find they become better at recognizing when they're tired, overwhelmed, or need connection, and at setting boundaries that honor those needs. Learning to trust your body is, in many ways, learning to trust yourself.
That trust is built gradually, through many small moments of listening and responding. It's not about getting it right every time. It's about returning to your body again and again, with patience.
Eating Disorder Therapy and Therapy for High Achievers in Philadelphia
An eating disorder can make your body feel like a place you need to escape from or control. Recovery offers another possibility: a body you can listen to, understand, and eventually trust.
You don't have to rebuild that connection alone. In therapy, we work together at a pace that feels manageable, building awareness of your internal experience, strengthening your ability to tolerate discomfort, and helping you reconnect with the wisdom your body has always carried.
If you're struggling with an eating disorder/disordered eating or slowing down and prioritizing yourself and want support, I'd love to help. Learn more about me here.
I offer eating disorder therapy in the Philadelphia area as well as therapy for high achieving and career driven individuals in Philadelphia.
Reach out here to schedule a free consultation call!