Eating disorders cloud judgment about the need for treatment
“You have to want to get better before you seek treatment”
Medical complications are significant, potentially irreversible, and life-threatening
An eating disorder can result in a 12-fold increase risk of death
Effective treatment leads to high rates of recovery

Eating disorders cloud judgment about the need for treatment.
Eating disorders usually begin with restrictive dieting to lose weight that may be quite benign in intent; however, there is a progressive loss in judgment necessary to make rational decisions about the merits of treatment. At first, dieting is not a matter for concern and may even lead to compliments from others. The initial focus on weight loss or control of food intake may lead to increased self-confidence, feelings of self-control and positive social feedback. Alternatively, it may begin to counteract certain negative feelings. However, with time, the attempt to control weight becomes more driven with a progressive fading of realistic perspective about the original goals as well as the adverse psychological, emotional, social and physical consequences. As the eating disorder advances further, there is often a growing abstinence obstinate rigidity in thinking, depression, anxiety, mood fluctuations, and social withdrawal. Later, the physical as well as social consequences may become more compromised even though blood tests remain normal and intellectual performance remains intact. Ultimately, depression, social isolation and progressive physical decline lead to failure to achieve educational, employment and social goals. However, the conviction that weight control is desirable and serves an essential purpose becomes so powerful that even the strongest suggestions to seek treatment are rebuffed.

“You have to want to get better before you seek treatment.”
This is a mistake since ambivalence about recovery is a symptom of eating disorders. Waiting until you “want to get better” may be too late. On one level, those with eating disorders can understand that symptoms are destructive; however, on another level, patients are terrified about the implications of recovery. The motivations in favor and against recovery are usually complex. For example, symptoms may serve a positive function of increasing self-control, self-confidence or self-protection. At the same time, many patients understand the negative consequences of their symptoms but feel helpless to change in the midst of self-hared about their physical appearance and suffer from chronic social insecurity and incompetence in other areas. Moreover, most patients know that they will probably feel worse at the beginning of treatment. Thus, those suffering from eating disorders need to know that the experienced professionals providing treatment do not expect them to be non-ambivalent and therapists can be expected to provide methods to improve motivation.


Medical complications are significant, potentially irreversible, and life-threatening.
The medical complications of eating disorders are significant, potentially irreversible, and life-threatening; thus, a medical evaluation is essential as part of a comprehensive assessment. Medical complications can involve almost all organ systems and can be viewed as consequences of starvation, vomiting, laxative abuse, binge eating, and exercise (Becker, Grinspoon, Klibanski, & Herzog, 1999; Pomeroy & Mitchell, 2002; Rome & Ammerman, 2003). Medical complications are not only evident during the acute phase of the disorder, but also there is an increased risk for a wide range of physical and emotional disorders years later (Johnson et al., 2002).

An eating disorder can result in a 12-fold increase risk of death.
The mortality rates for anorexia nervosa exceed the expected incidence of death from all causes among women 15-24 years of age by 12-fold and are about three times higher than other psychiatric disorders (Emborg, 1999; Sullivan, 1995). Mortality rates for bulimia nervosa are much lower but still not insignificant (Keel, Dorer, Eddy, Franko, Charatan, & Herzog, 2003; Nielsen, 2003). Psychological and physical impairment are common in long-term follow-up studies (Keel et al. 1999).

Effective treatment leads to high rates of recovery.
There have been major advancements in the treatment of both anorexia and bulimia nervosa in recent years. Although there are large variations across outcome studies, as many as 70% of adolescents with anorexia nervosa recover from their eating disorder if they receive proper treatment. However, the course can be difficult for these patients with some having persistent impairment (Patton, Coffey, & Sawyer, 2003; Steinhausen, Boyadjieva, Griogoroiu-Serbanescu, & Neumarker, 2003; Strober, Freeman, & Morrell, 1997). Long-term follow-up studies of adults with anorexia nervosa indicate a lower recovery rates; however, there are significant variations in outcome across follow-up studies (Steinhausen, 2002). The tremendous variability in treatment outcome from different centers, suggesting that the components for effective treatment exist but are not well established or consistently applied. Finally, community studies of those with eating disorders who never seek treatment indicate significant impairment for both anorexia (Wentz, Gillberg, Gillberg, & Rastam, 2001) and bulimia nervosa (Fairburn et al., 2003).

Fill out the short self-test EAT-26 to gather more information about whether you should consult a specialist regarding a possible eating disorder.