If you’ve been asking yourself, “Do I need treatment for an eating disorder?”, that is a sign you just might. Eating disorders can be very emotionally and medically serious, regardless of a person’s weight, size, or shape. Early support is key to making recovery possible, so it’s important you don’t wait until you think your labs are “bad enough,” or until you feel or look “sick enough.” Please know you deserve care—even before you’ve reached a crisis point.
Key Takeaways
- Signs of an eating disorder aren’t only seen around food or a person’s weight. They also show up in your thoughts, routines, overall health, and even in your relationships.
- If you can’t stop eating disorder thoughts and behaviors or if you are putting most of your day’s focus on food, exercise, or body image, it’s time to reach out for help.
- Risk and level of impairment—not looking a certain way or being a particular weight—are the signposts for whether treatment is needed.
- Getting an assessment will help you understand the available levels of care and which is best for you; it is not making a commitment to a treatment program.
Key Statistics
- Eating disorders have among the highest mortality rates of any psychiatric condition and can involve serious medical complications—regardless of weight.
- While there is overlap, warning signs of an eating disorder vary depending on diagnoses (anorexia nervosa [AN], binge eating disorder [BED], bulimia nervosa [BN], rumination disorder [RD], ARFID, OSFED, UFED).
- It’s not necessary to have all the physical signs of an eating disorder to indicate a serious issue that requires intervention. Behavior changes, emotional state, and overall health are part of the equation.
- Body Mass Index (BMI) should not be the only factor determining whether someone needs treatment or a higher level of care.
Do I Need Treatment for an Eating Disorder? A Quick Self-Check
Check in with yourself and ask the following. If your answer to any of the questions is “yes” (it doesn’t need to be every question), you may benefit from eating disorder treatment.
- Does food; your weight, size, or shape; and/or exercise take up a lot of your daily mental space?
- Do you feel anxious, guilty, or out of control around food and eating?
- Are you behaving in ways you are unable to stop? (Examples: bingeing, purging, restricting, taking laxatives, exercising compulsively.)
- Is your day-to-day life being negatively impacted? (Examples: lack of joy, cancelling social plans, difficulties at work or school, new problems in your relationships.)
- Have you been trying to “fix” these things on your own but it’s not working?
Signs it may be time for eating disorder treatment
The following signs can show up in any eating disorder (AN, BED, BN, RD, ARFID, OSFED, UFED) and often overlap.
1) Your eating has become rigid or rule-driven
- Skipping or delaying meals and snacks
- Avoiding meals with others or making excuses to get out of eating
- Eliminating food groups or shortening your list of “good” foods
- Intense food rituals (rearranging it on the plate, cutting it up, how or how much you chew, timing)
2) You’re engaging in behaviors you’re unable to stop
- Being secretive around food, eating, and/or body checking
- Binge eating or loss of control around food
- Compensation behaviors like purging (vomiting), fasting, or taking laxatives or diuretics
- Compulsive exercise and/or panicking when you can’t
3) Your emotions and relationships are being negatively impacted
- Increased anxiety, depression, irritability, emotional numbness, or shame
- Isolating from friends and skipping activities you used to enjoy
- Conflicts at home around meals or routines
- Feeling stuck in cycles
4) Your physical health is beginning to suffer
Even if your weight seems “normal,” an eating disorder can put you at serious medical risk. The following signs are among those that should be taken seriously:
- GI issues (constipation, bloating, reflux, vomiting)
- Dizziness, fainting, fatigue, weakness
- Shortness of breath, chest pain
- Sleep changes, mood instability, trouble concentrating
- Frequently cold
- Menstrual changes or loss of cycle (if applicable)
Signs you may need a higher level of care now
Outpatient care isn’t always enough, especially if your safety or medical stability is at risk. It’s important to know Body Mass Index (BMI) should not be the only factor determining whether someone needs treatment or a higher level of care. You should consider immediate evaluation or a higher level of care if:
- You’ve recently been hospitalized and need step-down care to stabilize
- You’re medically unstable (fainting, chest pain, confusion, dehydration)
- You’re feeling suicidal, engaging in self-harm, or can’t keep yourself safe
- You’re purging frequently or purging feels uncontrollable
- You’re losing weight rapidly or restricting a lot
- You’re unable to stop behaviors without supervision or support
The “not sick enough” trap
A very common eating disordered thought is: “I’m not sick enough to need treatment.” But it’s important you don’t wait for things to get worse; the longer you wait, the more entrenched the disease becomes, and the harder it is to recover. Early support is key. If your thoughts and behaviors are taking a toll on your inner peace, health, relationships, or time, reach out now; you deserve care.
What should I do next?
If you’re not sure what to do, start with these steps:
- Schedule an assessment with eating disorder professionals
- Get a medical checkup with your primary care physician or other M.D.
- Tell one safe person what you’re going through; it’s important you don’t carry it all on your own
- Reduce as many triggers as possible (examples: diet content, body-checking, comparison loops)
- Focus on stability over perfection: consistent nourishment and support first
What level of care might fit?
Levels of care are a continuum; recommendations are based on the individual’s medical risk, day-to-day functioning, and behavior frequency. A thorough, thoughtful assessment will inform what level of care is needed.
- Outpatient: Psychotherapy and nutrition support (usually for an early-stage eating disorder or in recovery but stable)
- Intensive Outpatient (IOP): Multiple days a week of structured programming
- Partial Hospitalization (PHP): Intensive daily programming that includes medical and clinical oversight; patients can go home at night
- Residential/Inpatient: Highest level of support; intensive 24/7 treatment for stabilization and patient safety
Q&A About Seeking Treatment
1) Could I need treatment even if I’m not underweight?
Yes. Eating disorders can be serious no matter what your weight. Clinical guides advise that BMI should not be the only factor determining whether someone needs treatment or a higher level of care.
2) What if I don’t know my diagnosis?
You shouldn’t self-diagnose. Instead, schedule an assessment with experienced professionals. They will identify and help you understand what you’re experiencing and recommend the best next steps for you.
3) Will treatment take over my life?
It’s common to fear treatment will take over your life. But the goal of treatment is to get you stabilized and provide you with support and tools to get your life back. Once you’re able to free yourself from constant noise about food and your body, you can find your way back to a more balanced and fulfilling life.
When Should I Seek Help?
If you’re experiencing chest pain, severe weakness, or confusion; aren’t able to keep food down or are purging uncontrollably; have fainted or are dehydrated, seek urgent medical care immediately.
If you’re experiencing suicidal thoughts or feel unable to stay safe, seek immediate crisis support. In the U.S., call or text 988 for the Suicide and Crisis Lifeline. Outside the U.S., contact your local emergency number or a local crisis line.
About Galen Hope – Trusted Treatment That Works
Galen Hope offers physician-led, individualized treatment programs for adolescents and adults of all genders struggling with eating disorders or complex mental health conditions. Our multidisciplinary teams take an integrated, whole-person approach to help clients stabilize in the acute stages and build the skills needed for long-term recovery.
If you’re not sure what level of care you need, we can help. We can provide a free assessment and verification of your insurance benefits so you can make an informed decision about care.
Contact us or call 866-304-2955 for a free assessment.
References:
- National Eating Disorders Association (NEDA). Warning Signs and Symptoms. National Eating Disorders Association
- National Institute of Mental Health (NIMH). Eating Disorders. National Institute of Mental Health
- NICE Guideline NG69. Eating disorders: recognition and treatment (including guidance not to use BMI alone).
- American Psychiatric Association. Practice Guideline for the Treatment of Patients With Eating Disorders (2023).
- Academy for Eating Disorders / Mass General. Eating Disorders Medical Guide (AED Report).