What Are Eating Disorders?

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Find a therapist to heal from an eating disorder

Clients may present with anxiety or trauma while eating disorder symptoms remain hidden.

Early recognition significantly improves long-term outcomes.

Routine screening and referral are core clinical competencies.

Eating disorders have one of the highest mortality rates of any psychiatric illness. Yet many therapists are not thoroughly trained to assess for them. Here is the reality: It is very likely that clients with eating disorders are already on your caseload. They may not have disclosed it. They may not meet full diagnostic criteria. Their symptoms may be early, evolving, partially treated, or carefully concealed. Eating disorders exist on a continuum, and clients seek therapy at many different points along it. Most do not walk in asking for help with an eating disorder.

They present with:AnxietyDepressionTraumaOCDRelationship distressBurnoutPerfectionism

In general mental health settings, eating disorder symptoms are often secondary, minimized, or entirely overlooked.

Eating Disorders Rarely Announce Themselves

Clients rarely say, “I think I have an eating disorder.” Instead, they may describe chronic dieting, rigid food rules, secretive eating, compulsive exercise, intense body dissatisfaction, or cycles of restriction and overeating.

Some behaviors are subtle.Some are longstanding but normalized.Some are escalating quietly.

In many cases, symptoms do not yet meet full diagnostic criteria. That does not mean they are benign. When eating disorder symptoms go unrecognized, treatment can stall. Mood instability persists. Trauma work feels destabilizing. Shame deepens. Medical risk increases without a clear explanation. The eating disorder remains in the background, shaping the clinical picture.

You May Be the First to Notice

Therapists are often in a unique position. You may be the first professional to recognize patterns, ask direct questions about food and body image, or sense that something more is occurring beneath the presenting concern. You do not need to provide specialized eating disorder treatment to play a critical role. But you do need the ability to:

• Recognize early and subthreshold warning signs• Understand that eating disorders cut across body sizes, genders, races, and ages• Conduct routine screening rather than waiting for disclosure• Avoid reinforcing weight stigma or diet culture narratives• Clarify when referral to specialized care is indicated

Accurate recognition and timely referral can meaningfully alter both psychiatric risk and long-term outcomes.

Eating disorders are frequently missed. Most graduate programs devote minimal time to assessing eating disorders. Screening is rarely standardized. Many clinicians feel uncertain about initiating conversations about food, weight, and body image. Bias also plays a role. Assumptions about who “looks like” they have an eating disorder contribute to underdiagnosis, particularly in larger bodies, in men, and in high-functioning adults. Without intentional assessment, eating disorders remain hidden in plain sight.

This Is Foundational, Not Specialty Knowledge

The ability to recognize eating disorders is not niche expertise. It is foundational clinical competence. You may not be the clinician who treats the eating disorder directly. But your ability to detect warning signs, clarify next steps, and support appropriate referral can shift the trajectory of care. Clients with eating disorders are already present in general mental health settings. The question is not whether they are there. The question is whether we are prepared to see them.

What Are Eating Disorders?

Take our Disordered Eating Test

Find a therapist to heal from an eating disorder

Arcelus, Jon et al. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry 68,7 (2011): 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74

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