Diagnosis

Eating disorders are diagnosed based on signs, symptoms and eating habits. If your doctor suspects you have an eating disorder, he or she will likely perform physical and psychological exams and request tests to help pinpoint a diagnosis. You may see both a medical doctor and a mental health provider for a diagnosis.

Exams and tests generally include:

  • Physical exam. Your doctor will likely examine you to rule out other medical causes for your eating issues. He or she may also order lab tests.
  • Psychological evaluation. A doctor or mental health provider will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete psychological self-assessment questionnaires.
  • Other studies. Additional tests may be done to check for any complications related to your eating disorder. Evaluation and testing may also be done to determine your nutritional requirements.

Diagnostic criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for various eating disorders. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Each eating disorder has its own set of diagnostic criteria. Your mental health provider will review your signs and symptoms to see if you meet the criteria for a specific eating disorder. Some people may not meet all of the criteria but still have an eating disorder and need professional help to overcome or manage it.

Treatment

Treatment of an eating disorder generally includes a team approach. The team typically includes medical providers, mental health providers and dietitians — all with experience in eating disorders.

Treatment depends on your specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication.  If your life is at risk, you may need immediate hospitalization.

Psychotherapy

Psychotherapy, also called talk therapy, can help you learn how to replace unhealthy habits with healthy ones. This may include:

  • Cognitive behavioral therapy (CBT). CBT is commonly used in eating disorder treatment, especially for bulimia and binge-eating disorder. You learn how to monitor your eating and your moods, develop problem-solving skills and explore healthy ways to cope with stressful situations. Psychotherapy can also help improve your relationships and your mood.
  • Family-based therapy (FBT). FBT is an evidence-based treatment for children and teenagers with eating disorders. The family is involved in making sure that the child or other family member follows healthy-eating patterns and maintains a healthy weight.

Weight normalization and nutrition education

If you're underweight due to an eating disorder, the first goal of treatment will be to start getting you back to a healthy weight. No matter what your weight, dietitians and other health care providers can give you information on a healthy diet and help design an eating plan to help you achieve a healthy weight and learn normal-eating habits.

Hospitalization

If you have serious health problems, such as anorexia that has resulted in severe malnutrition, your doctor may recommend hospitalization on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.

Medications

Medication can't cure an eating disorder. However, certain medications may help you control urges to binge or purge or to manage excessive preoccupations with food and diet. Drugs such as antidepressants and anti-anxiety medications may help with symptoms of depression or anxiety, which are frequently associated with eating disorders.

Lifestyle and home remedies

When you have an eating disorder, taking care of yourself can help you feel better during and after treatment and help maintain your overall health.

Try to make these steps a part of your daily routine:

  • Stick to your treatment plan — don't skip therapy sessions and try not to stray from meal plans.
  • Talk to your doctor about appropriate vitamin and mineral supplements to make sure you're getting all the essential nutrients.
  • Don't isolate yourself from caring family members and friends who want to see you get healthy and have your best interests at heart.
  • Talk to your health care providers about what kind of exercise, if any, is appropriate for you.
  • Read self-help books that offer sound, practical advice. Your health care provider may recommend some helpful resources.
  • Resist urges to weigh yourself or check yourself in the mirror frequently. This may simply fuel your drive to maintain unhealthy habits.

Alternative medicine

Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine.

Usually, when people turn to alternative medicine it's to improve their health. But there are numerous dietary supplements and herbal products designed to suppress the appetite or aid in weight loss, and these products may be abused by people with eating disorders. Such products can have potentially dangerous interactions with other medications.

Additionally, weight-loss supplements or herbs can have serious side effects, such as irregular heartbeats, confusion, nausea, dizziness and nervousness.

Talk with your doctor before trying any alternative medicine. Natural doesn't always mean safe. Your doctor can help you understand possible risks and benefits before you try a treatment.

Reduce stress and anxiety

Complementary treatments may help reduce anxiety in people with eating disorders. Such treatments may help people with eating disorders by reducing stress, promoting relaxation and increasing a sense of well-being.

Examples of anxiety-reducing complementary treatments include:

  • Acupuncture
  • Massage
  • Yoga
  • Meditation

Coping and support

It's difficult to cope with an eating disorder when you're hit with mixed messages by the media, culture, and perhaps your own family or friends. Whether you or your loved one has an eating disorder, ask your doctor or therapist for advice on coping and emotional support.

Learning effective coping strategies and getting the support you need from family and friends are vital to successful treatment.

Preparing for your appointment

Here's some information to help you get ready for your appointment, and what you might expect from your doctor and other health providers.

What you can do

Before your appointment, make a list of:

  • Any symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment
  • Key personal information, including any major stresses or recent life changes
  • All medications, vitamins or other supplements that you're taking, and their doses
  • Questions to ask your doctor so that you'll remember to cover everything you wanted to

Ask a family member or friend to come with you, if possible. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.

Some questions you might want to ask your doctor or other health care provider include:

  • What kinds of tests do I need? Do these tests require any special preparation?
  • Is this condition temporary or long lasting?
  • What treatments are available, and which do you recommend?
  • How will treatment affect my weight?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor or other health care provider is likely to ask you several questions, such as:

  • How long have you been worried about your weight?
  • Do you exercise? How often do you exercise and for how long?
  • Have you found any other ways to lose weight?
  • Are you having any physical symptoms?
  • Have you ever vomited because you were uncomfortably full?
  • Have others expressed concern about your weight?
  • Do you think about food often?
  • Do you ever eat in secret?
  • Have any of your family members ever had symptoms of or been diagnosed with an eating disorder?