You are not alone...

Admitting you have an eating, exercise, or body image problem that requires treatment is a difficult step to take and getting the right help is essential! There are a variety of treatment options available: individual therapy, group therapy, nutritional support, psychiatric care, outpatient, inpatient, residential, etc. Please know that there are resources available to assist you and your loved ones!

If there are specific questions or you would like assistance with please feel free to call the International Referral Organization at 858-792-7463, or you can e-mail S.P.E.A.K. at . We would be happy to assist you in locating treatment options in your area.

TREATMENT OVERVIEW: There is Help Available! (top)

It is generally accepted that the treatment of eating disorders must often involve clinicians from different health disciplines including psychotherapists, physicians, nutritionists, and nurses SIMULTANOUSLY. Research on the treatment of eating disorders is exploring the various ways in which specific treatments can be matched to specific subtypes of these disorders. The consensus is that good treatment often requires a spectrum of treatment options. These options can range from basic psycho-educational interventions designed to teach nutritional and symptom management techniques to long-term residential placements.

Most individuals with eating disorders are treated on an outpatient basis after a comprehensive evaluation. Those with medical complications due to severe weight loss or due to the effects of bingeing and purging may require inpatient treatment or hospitalization. Other individuals, for whom outpatient therapy has not been effective, may benefit from day-hospital treatment, hospitalization, or residential placement. Treatment is usually conducted in the least restrictive setting that can provide adequate safety for the individual. Many patients with eating disorders also have depression, anxiety disorders and other psychiatric problems requiring treatment along with the eating disorder.

Eating disorders are physically and emotionally destructive. People with eating disorders need to seek professional help immediately. Early diagnosis and intervention significantly enhance recovery. If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and life threatening.

Initial Assessment, Diagnosis, Development of Treatment Plan:

The first step in establishing a diagnosis and treatment plan is the initial assessment. The initial assessment of eating disorder patient involves:

  • Review of patient's history.
  • Review of current symptoms presented.
  • Assessment of physical status.
  • Assessment of other psychiatric issues or disorders such as depression, anxiety, substance abuse, or personality issues.

What does treatment involve?

The most effective treatment for an eating disorder is psychotherapy or psychological counseling, along with medical and nutritional support and guidance. The treatment should be individually tailored. Treatment will vary depending on the severity of the disorder and the client's particular problems, needs, and strengths.

Psychological counseling needs to address both the eating disordered symptoms and the underlying psychological, interpersonal and cultural forces that contributed to the eating disorder.

  • The individual needs to learn how to live peacefully and healthfully with themselves and food.
  • Care should be coordinated and provided by a health professional with expertise and experience in dealing with eating disorders.
  • Typically, care is provided by a licensed health professional, including but not limited to a psychologist, psychiatrist, nutritionist, and medical doctor.


Outpatient Care

Many people with eating disorders respond very well to outpatient therapy. There are several types of outpatient psychotherapies with demonstrated effectiveness in treating patients with eating disorders. Cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and behavioral therapy have all shown promising results in treating eating disorder sufferers. Outpatient treatment for an eating disorder often involves a coordinated effort between the client, a psychotherapist, and a physician.. Also, regular consultations with a registered dietician can be an effective means of support and information for patients who are regaining weight or normalize their eating. Patients with eating disorders are subject to a variety of physical and medical concerns, thus adequate medical monitoring is essential to effective outpatient treatment.

Psychopharmacology: Psychiatric medications have a demonstrated role in the treatment of patients with eating disorders.

Day Hospital Care

Some clients may need more structure and contact than outpatient treatment can provide. These clients may benefit from the increased structure provided by a day-hospital treatment program. Day treatment programs provide structured eating situations and active treatment interventions while allowing the individual to live at home and in many continue to work or to attend school.

Inpatient Care

Inpatient treatment provides a structured environment in which the client has access to clinical support 24-hours a day. Some of these are within larger hospitals, while others are privately supported. Many programs are affiliated with day and outpatient programs that allow clients to step up or down to the appropriate level of care depending on their clinical needs.

Residential Care

Residential programs provide long-term treatment for those with eating disorders. This can range anywhere from two weeks to over a year. Residential programs very extensively in the services they provide, but most include a variety of therapy sessions with adequate medical care 24 hours a day.

The treatment needs of each individual will vary. It is important for those struggling with an eating disorder to find a mental health care professional they trust to assist in developing and coordinating their treatment plan. Please check out our resource link for professionals in the Ann Arbor area or contact us at for more information.

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Making the decision to tell others about your eating disorder can be very difficult. You have many fears about taking this step and you probably feel embarrassed and ashamed. Here are some of the questions S.P.E.A.K. members had in common:

"Will they understand?" Some people will understand or be willing to understand while others will not. Some will make an effort to learn more about your disorder so they can better help you. Others of course may not be so understanding and may be unwilling to educate themselves on the topic. As hard as it may be, this is a fact of life and chances are, these people are just plain ignorant.

"Will people make fun of me?" If the person you are telling truly loves and cares about you, the information you give them will be anything but funny or something to poke fun at. However, there are people who can be hurtful. If this happens, you will have to try to avoid them and accept them as being plain ignorant. They have no right to treat you unkindly.

"How will they react?" This is a difficult question as each person reacts in different ways. You can never predict how someone will react. The reaction I think is what we fear the most and what stops us from telling. Everyone you tell won't react the same way. Some people may be shocked while others have already suspected your condition. Others may be so upset that they cry and others will say nothing, not knowing how to respond to your news. You may have to give people time to absorb what you told them, to let it sink in. Be prepared to answer some questions as they may and will probably have lots to ask you.

"Will they think I'm nuts?" People who take the time to understand you and your Eating Disorder will not label you as being crazy or even nuts. Those who may are insensitive and ignorant on the topic of Eating Disorders.

"Will people treat me different?" It may take time for people, especially family to come to accept the fact that you have an Eating Disorder. They may not know what to say to you or what to do so they may try to avoid you. They do this because they feel uncomfortable and don't know how to respond to you. In time, people will come around as they better understand you and the disorder.

"Will people desert me?" The people who truly love and care about you will not abandon or leave you during a time in your life that you need them most. This is a time in your life when you will learn and see the people who are there for you and the ones who are not. If you are married or in a relationship, an Eating Disorder can cause a great deal of stress to your marriage or relationship. While it is true that in spite of all efforts some marriages break down, there are other marriages that flourish and couples grow and become stronger together. If you are not one of those fortunate ones and you feel your marriage is suffering, you may want to consider therapy with your partner and/or marriage counseling.

"Will my parents get mad at me?" Some parents have a hard time dealing and accepting the fact that their child has an Eating Disorder. Too often parents will blame themselves and struggle with a great deal of guilt over it. These are feelings they will have to face and deal with, it's not your fault or problem. Some parents will show anger out of frustration, guilt, worry and fear. There are also parents who don't get angry who turn out to be wonderful support systems. Again, remember it is hard to predict how your parents or anyone else will react. You will have to take the worthwhile risk to find out.


Here are a few ideas to help you along if you are deciding to tell someone about your eating disorder.

Don't fear the worst! Things aren't always as bad as we anticipate them to be. You have to first take the risk to discover what the true outcome will be.

Tell someone you trust. First, you can start by telling a close friend or family member that you trust. It is important that you feel comfortable with that person and feel comfortable talking to them.

Bring someone with you. If you are telling your family and will have great difficulty, consider having a friend with you for support and encouragement. Having a therapist present while you talk to your family can also provide you with more security. The therapist can offer information, help discuss feelings and be there to answer questions.

Bring information with you. The person you choose to tell may not know a lot about Eating Disorders and maybe even nothing at all. It would be a good idea to bring a book or sheets of information you have about eating disorders.

Write a letter. When it is too difficult to say things verbally to someone writing a letter can be a great way to communicate. You can tell someone about your eating disorder in a letter and express your thoughts, feelings and fears. You can take time to write your letter and give more time as to how to say things. This also gives the recipient of your letter time to react and think about your letter and they can even reread your letter if they wish and need to. A letter is a good idea if you are too afraid to tell but want someone to know.

Telling someone about your eating disorder will take courage and whom you tell and when is your choice. You must do what is best for you. There is no right or wrong way to tell someone, you will have to do it your own way that you feel is right for you.


If you are browsing this web site, then chances are, you are concerned about the eating habits, weight, or body image of someone you care about. We understand that this can be a very difficult and scary time for you. Let us assure you that you are doing a great thing by looking for more information!! This list may not tell you everything you need to know about what to do in your specific situation, but it will give you some helpful general ideas on what to do to help your friend.

If you are worried about your friend's eating behaviors or attitudes, then it is appropriate for you to express your concerns to her in a loving and supportive way. It is important to handle these issues with honesty and respect. It is also important to discuss your worries early on, rather than waiting until your friend has endured many of the damaging physical and emotional effects of eating disorders.

  • In a private and relaxed setting, talk to your friend calm and caring way about the specific things you have seen or felt that have made you worry.
  • Learn as much as you can about eating disorders. Read books, articles, and brochures.
  • Know the differences between facts and myths about weight, nutrition, and exercise.
  • Knowing the facts will help you reason against any inaccurate ideas that your friend may be using as excuses to maintain his/her disordered eating patterns.
  • Be honest. Talk openly and honestly about your concerns with the person who is struggling with eating or body image problems. Avoiding it or ignoring it won't help!
  • Be caring, but be firm. Caring about your friend does not mean being manipulated by her. Your friend must be responsible for her actions and their consequences. Avoid making "rules," promises, or expectations that you cannot or will not uphold (For example, "I promise not to tell anyone." or, "If you do this one more time I'll never talk to you again.").
  • Share your memories of two or three specific times when you felt concerned, afraid, or uneasy because of her eating rituals. Talk about the feelings you experienced as a result of these events. Try to do this in a very supportive, non-confrontational way. Here are three suggestions:
  1. Use "I" statements. For example: "I'm concerned about you because you refuse to eat breakfast or lunch." or "It makes me afraid to hear you vomiting."
  2. Avoid accusatory "You" statements. For example: "You have to eat something!" " You must be crazy!" or "You're out of control!"
  3. Avoid giving simple solutions. For example: "If you'd just stop, everything would be fine!"
  • Tell someone! It may seem difficult to know when, if at all, to tell someone else about your concerns. Addressing body image or eating problems in their beginning stages probably offers your friend the best chance for working through these issues and becoming healthy again. Don't wait until the situation is so severe that your friend's life is in danger. If you have already spoken with your friend and still feel like more steps need to be taken to address these issues, consider telling her parents, a teacher, a doctor, a counselor, a nutritionist, or any trusted adult. She needs as much support and understanding as possible from the people in her life.

Remember: You cannot force someone to seek help, change their habits, or adjust their attitudes. You will make important progress in honestly sharing your concerns, providing support, and knowing where to go for more information! People struggling with anorexia, bulimia, or binge eating disorder do need professional help. There is help available, and there is hope!