Persons with eating disorders often have difficulty admitting that they have a serious problem, and in many cases, particularly with anorexia, family or friends must persuade the individual to seek treatment.

In treating anorexia nervosa, the first step is the restoration of normal body weight. The greater the patient’s weight loss, the more likely the individual is to require hospitalization to ensure adequate food intake. Outpatient programs have become common in recent years; some centers have day programs where patients may spend eight hours a day, five days a week.

Anorexic patients are given a carefully prescribed diet, starting with small meals and gradually increasing the caloric intake. Each patient is given a goal weight range, and as she or he approaches the ideal weight, more independence in eating habits is allowed. If, however, she or he falls below the set range, greater supervision may be reinstated.

As they begin to gain weight, each patient usually will begin individual, as well as group, psychotherapy. Counseling usually involves education about body weight regulation and the effects of starvation, clarification of dietary misconceptions, and working on the issues of self-control and self-esteem. Follow-up counseling for anorexia may continue for six months to several years after healthy weight is restored.

Treatment of bulimia nervosa first involves the management of any serious physical complications. In some cases, when the binge-purge cycle is so severe that the patients cannot stop on their own, hospitalization may be necessary. In such instances, individual counseling, sometimes combined with medication, is the standard treatment.

Counseling involves issues similar to those discussed in the treatment of anorexia and usually lasts for about four to six months.