Play Therapy with Children & Teens Experiencing Eating Problems

I’m so excited to dive into a topic today that doesn’t get talked about enough in the play therapy world: disordered eating in children and adolescents.

In this episode, I got the chance to sit down with one of our amazing Play Therapy Academy members—Leah Evans, LPC, RPT. Leah is based in Texas and has such a compassionate and deeply informed approach to working with kids who are navigating eating issues.

Whether you’re a play therapist, a mental health professional, or just someone who works with children, my hope is that this episode gives you new insight into how we can better support our clients—and their families—when eating becomes part of the therapeutic picture.

Why Disordered Eating Isn’t Just About Food

Let’s start here: disordered eating is not always about the food.

Leah shared how these behaviors often connect to anxiety, sensory issues, trauma, or a deep need for control. That really resonated with me. Because if we as therapists don’t recognize those underlying patterns, we might mistake the behavior as defiance, attention-seeking, or “just a phase.”

“We have to ask—what’s driving this? What’s underneath the surface?”

When we don’t take the time to understand what’s really going on, we risk missing the opportunity to truly help a child heal. That’s where case conceptualization becomes a foundational piece of the puzzle.

What Should We Be Looking For?

If you’re working with kids or teens, here are a few things Leah suggests paying attention to:

How does the child act at mealtimes?
Is there anxiety, rigidity, or shame around food?
Are there compensating behaviors (e.g., excessive exercise, restriction)?
Do parents describe food as a power struggle?

And for the younger kids who can’t quite articulate their experience yet, it becomes even more important to rely on parent interviews, play observation, and a good psychosocial assessment.

Knowing When to Refer (And Who to Refer To)

Something Leah really emphasized—and I couldn’t agree more—is the importance of collaboration. We can’t do this alone. Sometimes, we need to loop in:

Dietitians (but make sure they’re trained in eating disorders!)
Pediatricians for bloodwork and growth tracking
Occupational therapists (especially if sensory issues are in play)

“If I don’t know it, I find someone who does,” Leah said. And honestly, that’s how we best serve our clients.

Working with Parents Is Not Optional

Here’s where it gets personal. I’ve shared before that my own kids are neurodiverse—and boy, did we have some food challenges when they were little! My son would not eat vegetables. One time, he refused to touch a pizza because it had parsley flakes on it. (We still laugh about that one.)

But here’s the thing—I learned quickly that parenting around food requires patience, trust, and no power struggles. If a child doesn’t feel safe around food, and the parent doubles down with control or fear-based tactics? It just gets worse.

That’s why in our work as play therapists, we have to bring parents into the process. Explore their attitudes toward food, their own histories, and how culture or generational beliefs play into the way they feed their kids.

So How Does Play Therapy Actually Help?

This is where it gets really fun—because play therapy is such a powerful tool for helping children explore and express their relationship with food.

Leah uses both Child-Centered Play Therapy and Adlerian Play Therapy, depending on the child’s needs and age. And she shared some brilliant examples of what that looks like in action:

With Younger Kids:

Play kitchens help kids express mealtime experiences and anxieties.
Hungry Hungry Hippos becomes more than just a game—it's a metaphor. Some kids assign colors to “safe” or “poisonous” foods, giving us insight into their fears and beliefs.

“Sometimes it doesn’t feel safe to try something new,” Leah said. And play gives kids a way to say that without words.

With Older Kids:

Leah leans into values exploration and cultural identity using Adlerian tools. They explore what’s part of their culture, how food and body image fit into that, and how it relates to the Crucial Cs—courage, connection, capability, and counting.

Diet Culture and Social Messages—Yes, It Affects Kids Too

Especially with older kids and teens, diet culture is everywhere—from media to peer interactions to what’s said at home. And these messages don’t just go over their heads; they stick.

That’s why during parent consults, I often ask:

“What are the attitudes around food in your house?”
“What messages have your children picked up from you or others?”
“How do you talk about your own body?”

These are powerful questions. And they can lead to healing shifts—not just for the child, but for the entire family.

What I Love About Play Therapy Academy (And How It Helped Leah)

Leah also shared that joining Play Therapy Academy helped her expand how she conceptualizes cases, especially with eating issues. She said:

“I already had the play therapy basics down, but I was craving connection and collaboration. PTA helped me zoom out and see the whole picture.”

That’s exactly why I created this program—to help therapists deepen their skills, get confident with case conceptualization, and have a safe space to learn from each other.

Final Thoughts

This conversation with Leah was so rich—and honestly, we could’ve talked for another hour! Disordered eating in children is complex, but with the right tools, the right support, and the right mindset, we can help our clients heal, grow, and thrive.

For more information about Leah Evans, check out her Psychology Today profile.

And if you're thinking, “I want to strengthen my skills and join a supportive learning community,” then come check out Play Therapy Academy. You can book a free 30-minute Zoom call with me to see if it's the right fit for you.

Categories: : Assessment, Case Conceptualization, Play Therapy Academy, Play Therapy Model, Podcast, Supervision, Trauma