Anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) arise from a combination of biological, cultural, psychosocial and personality factors. Although these illnesses are treatable -- often successfully so -- many individuals are reluctant to seek professional help. Some are unable or unwilling to admit they have a disorder while others acknowledge they have a problem but continue to cling to their abnormal eating behaviors, often as an attempt to cope with difficult emotions. In addition, many who suffer from these illnesses feel ashamed of their eating habits and don’t like to mention them. Even when individuals begin to realize that they need help, they may be ambivalent about seeking it.

People with anorexia nervosa, bulimia nervosa, or EDNOS (or with histories of these conditions) sometimes go to a health professional for help with abdominal discomfort, fatigue, headaches, infertility, depression or a sports injury but not offer information about their eating or exercise habits. Yet treatment for an eating disorder is often most successful when provided early in the course of the illness. It is important for health and education professionals to understand that shame can be an obstacle to disclosure, and to use a gentle, non-threatening approach when reaching out to at-risk individuals.

Due to the multi-faceted, complex nature of eating disorders, a comprehensive, interdisciplinary (team) approach to treatment is generally recommended, including primary care support, psychotherapy, psychopharmacology, and nutrition counseling. Conscientious dental care is also advised. One member of the treatment team, often the psychotherapist, serves as leader, taking ultimate responsibility for making decisions. The importance of collaboration among team members cannot be emphasized enough. Teachers, athletic coaches and school guidance counselors often provide input as well.

Eating disturbances develop in individuals from all socioeconomic and racial backgrounds. Sensitivity to patients’ ethnic and cultural identities is an integral part of treatment.

The goals of treatment may include:

• Restoring the patient’s nutritional health
• Decreasing abnormal eating behaviors
• Preventing or managing medical complications
• Improving the patient’s motivation to participate in treatment
• Helping the individual re-evaluate and modify thoughts and feelings that may perpetuate the eating disorder
• Treating mental illnesses (such as major depression, anxiety disorder, substance use disorder) or behavioral issues (such as cutting, stealing, immoderate sexual activity) that may co-exist with an eating disorder
• Providing education or therapy to the patient’s family
• Teaching the individual to avoid relapse