This resource was written by Donna Hillier, PsyD
At Galen Hope, we know eating disorders affect people in every community and at every income level. For many high-net-worth individuals and high-visibility leaders, perfectionism, privacy needs, and performance pressure can make recognizing a problem, and seeking help, especially complex. We’re honored to share this guest piece by Donna Hillier, PsyD, a licensed clinical psychologist with deep experience supporting high-achieving clients.
The Private Struggles Behind Public Success
Eating disorders don’t discriminate. They affect people across all income brackets, cultures, genders, and ages. However, for high-net-worth individuals (HNWIs), the signs are often harder to spot. On the surface, everything looks polished: disciplined, accomplished, and in control. But underneath, the very traits that fueled their success—relentless drive, rigid control, perfectionism—can quietly turn into a painful, private struggle with food and the body.
In my work with individuals and families affected by eating disorders, I’ve had the privilege of supporting elite performers, celebrities, founders, and ultra-high-net-worth individuals. Many of whom suffer in silence behind lives that seem outwardly composed. Their struggles are rarely about food itself. More often, they’re about identity, worth, control, invisibility, and the heavy pressure of being seen as “exceptional.”
Below are five unique reasons individuals from affluent and achievement-focused backgrounds may develop or maintain eating disorders. These insights go beyond the surface to offer understanding, compassion, and ultimately, hope for change.
1. The Illusion of Control in an Unpredictable Life
Wealth often brings opportunity, but it does not guarantee protection. HNWIs live under extraordinary pressure. From managing generational family businesses to leading billion-dollar companies, they’re constantly navigating high-stakes environments. While their outer world appears organized and powerful, their inner world can feel chaotic, uncertain, or emotionally neglected.
In this environment, food and body become a domain they can control when so much else feels uncertain. Whether through restrictive eating, purging, or compulsive exercising, disordered behaviors can offer a temporary sense of order. In families where privacy is paramount and emotional expression is frequently discouraged, controlling food may become the only way to manage emotions they were never taught to express.
Control isn’t inherently negative; it’s often a necessary survival strategy. The challenge arises when it becomes the only strategy. Real healing means working with that same drive and discipline, not against it, and redirecting those strengths toward building internal steadiness. The goal is to cultivate a deeper sense of emotional safety. One that is rooted in self-trust, where control becomes flexible, responsive, and grounded in inner stability.
2. The Performance Identity: When Worth Is Always on the Line
Many affluent individuals from achievement-focused environments have built their lives around performance. Their identities are closely tied to being the smartest, the most successful, the most composed. However, when self-worth depends entirely on achievement and appearance, it becomes unstable, easily shaken by a setback, a misstep, or even a moment of genuine vulnerability.
The body, too, becomes yet another performance metric. Thinness, muscularity, or a carefully curated aesthetic becomes a symbol of discipline, status, and control. Any deviation from this ideal can provoke deep shame, even fear of being “found out” as not enough.
For those who grew up in high-achieving or image-focused families, the seeds of this performance identity are often planted early. Appearances mattered. Praise had to be earned. Emotions were managed privately. Over time, the message sinks in: value is something to prove, not something you inherently possess.
Recovery begins with the realization that your worth was never meant to hinge on achievement. From this place, you can redefine ambition on your own terms. As you rebuild from within, success becomes a natural expression of inner clarity, confidence, and purpose. It no longer measures your value; it reflects the strength and wholeness you’ve built within.
3. Emotional Invisibility in Wealthy Families
In families of significant wealth, emotional needs are often eclipsed by reputational concerns, legacy planning, or the logistics of managing large-scale responsibilities. Love is sometimes expressed through provision: education, access, opportunity rather than emotional presence. And in environments where privacy is paramount, vulnerability can feel unsafe or even taboo.
Some clients describe childhoods where caregivers were physically present but emotionally distant, or where nannies provided more emotional availability than parents. Others recall an atmosphere where perfection was expected and emotional expression quietly discouraged. The result is often a deep internal message: “My feelings don’t matter,” or “If I’m hurting, I need to hide it.”
Restriction may become a way to numb or disappear. Bingeing may express a hunger for connection. Purging may be an attempt to expel unwanted feelings. Disordered eating becomes a private ritual in response to unmet emotional needs.
Healing in this context means learning to recognize emotional needs not as liabilities, but as signals of life and humanity worthy of attention, care, and safe expression. Validating these needs and learning how to meet them in nourishing ways is an act of reclaiming emotional visibility and psychological dignity.
4. Isolation at the Top: The Cost of Privacy and Power
Success can be profoundly isolating. The more wealth and influence a person holds, the fewer safe spaces they have to be truly known. Many HNWIs fear being judged, manipulated, or misunderstood. Trust is hard-earned. Vulnerability feels dangerous. This kind of isolation can quietly set the stage for disordered eating to take hold.
Without safe emotional connection, individuals may turn inward, using food or body-focused rituals to self-soothe, suppress emotion, or create a sense of control. Some may even engage in extreme fasting or overexercise as private rituals of comfort or mastery. In the absence of meaningful support, an eating disorder can become a hidden companion—reliable, familiar, and deeply private.
Even in high-stakes, high-visibility lives, healing is possible. It starts by creating spaces, often in therapy, where someone is allowed to be fully human. Not impressive. Not invulnerable. Just real.
That kind of safety is where recovery takes root. The kind that gives you the strength to face and work through the fear that once kept you hidden. That’s when being fully seen becomes possible, and healing begins.
5. Affluence Magnifies Cultural Pressures and Creates New Ones
Individuals in affluent and image-driven communities live under a magnifying glass. Public image, curated social media, exclusive circles—all reinforce narrow and often punishing beauty standards. For women especially, the pressure to look effortlessly youthful and slim can feel suffocating. For men, the ideal often involves strength, dominance, and emotional invulnerability.
Wealth amplifies these pressures because image becomes part of the brand. If you’re in the public eye, on boards, on red carpets, or running billion-dollar firms, your appearance is constantly evaluated. HNWIs also face unique pressures from within their circles. In some elite communities, extreme health fads, biohacking, and aesthetic interventions are normalized, making disordered behaviors seem socially acceptable, even aspirational. Over time, it becomes hard to tell where health ends and harm begins.
In a world where image is currency and has long been your armor, choosing authenticity over perfection becomes a bold, quiet revolution. For those healing from an eating disorder, stepping off the treadmill of appearance isn’t just radical; it’s a profound act of self-respect and personal power.
Recovery invites a different kind of strength—the kind that channels your drive in ways that support your wholeness instead of depleting it. It’s where achievement flows from self-worth, rather than the need to prove it. It’s a deliberate choice to prioritize well-being: to honor your health, energy, and inner peace as your true measure of success.
This shift is about valuing authenticity over performance, showing up as your real self, not a curated version designed to meet others’ expectations. It’s about redefining success and creating new standards in a way that is sustainable, human, and deeply aligned with who you are.
The rules can be rewritten, and your worth has never depended on how well you followed them.
What Healing Looks Like for HNWIs
For high-net-worth individuals, healing from an eating disorder means redirecting your strengths of ambition, discernment, or achievement toward sustainable inner stability and emotional well-being.
Therapeutic work becomes a place to:
- Unpack early experiences that shaped one’s sense of self-worth, control, and emotional visibility
- Identify values that extend beyond image or performance
- Develop emotional tools for regulation, expression, and connection
- Strengthen a sense of identity that isn’t tethered to achievement
- Build relationships grounded in trust, safety, and authenticity
High-net-worth individuals often navigate complex relational, reputational, and professional dynamics that quietly shape struggles with food, body image, and control. Effective treatment must reflect this complexity. Truly impactful care goes beyond the clinical; it must be discreet, flexible, and emotionally nuanced. A tailored, relational, and psychologically sophisticated approach that meets clients where they are, honors their lived experience, and cultivates meaningful, lasting healing can make all the difference.
Final Thoughts: Why Eating Disorders Affect High-Net-Worth Individuals and the Path to Healing
One of the most common things I hear from high-net-worth clients is this: “I should be able to handle this. Other people fall apart. I don’t.”
The reality is emotional pain doesn’t check your net worth. It doesn’t pause for success or status. An eating disorder isn’t a sign of weakness; it’s a signal that something within needs care, safety, and the chance to be seen and understood. If any of this feels familiar, know that you are not broken. You’re not alone. Healing is absolutely possible—even for you.
You don’t have to give up your ambition, your success, or your edge to get well. You simply need to know that your worth isn’t tied to how in control you appear or how much you can carry.
Beneath the titles, the roles you fulfill, and the responsibilities you carry, you are a remarkable human being because you feel deeply, care genuinely, strive earnestly, and long for more than simply appearing okay. That humanness, the part of you that aches, questions, and quietly hopes, is a reflection of your depth, resilience, and capacity to grow. It’s what makes you real, and being real is more than enough to be worthy of healing, connection, and peace.
About Donna Hillier, PsyD
Dr. Hillier is a licensed clinical psychologist with over 20 years of experience working with high-net-worth individuals, public figures, and elite professionals who value discretion, depth, and a space where they can truly be themselves. My work is rooted in research-based methods and personalized care, helping clients move through complex emotional, relational, and professional challenges with clarity, self-compassion, and lasting strength.
I provide discreet psychological and professional coaching services tailored to the unique pressures of high-stakes leadership, visibility, and legacy. Serving clients nationwide and across the globe, I work with high-achieving individuals who seek meaningful growth, renewed purpose, and trusted support outside of the public eye. My clients are extraordinary people navigating intensely private realities, and it’s an honor to walk alongside them in their most transformative work. I see each of them as the hero in their life story and remain deeply inspired by their courage, insight, and capacity for renewal.
Galen Hope: When a Higher Level of Care Is Needed
If outpatient support isn’t enough, Galen Hope provides physician- and psychologist-led, treatment for eating disorders and mental health conditions, tailored to each individual..
Our levels of care include Partial Hospitalization (PHP) and Intensive Outpatient (IOP), with supported housing options; Residential is coming soon. Programs are designed with discretion and flexibility, integrating family and community support to meet clients where they are. For those who need more than weekly therapy, Galen Hope offers structured day and intensive programming that centers dignity, privacy, and lasting recovery. With two locations in South Florida, Galen Hope currently offers in-person programming for adolescents and adults of all genders. For more information, please visit www.galenHOPE.com