The latter. Eating disorders cause major damage to the body. They have the highest rate of mortality of all mental disorders. The sooner you stop damaging your body, the sooner it can begin to heal.
You might never learn what drives your behavior, but you can still be successful in treatment. Many modern-day treatments tend to be focused on the “here and now.” You may come to learn what motivates your behavior, with counseling, but it is not a prerequisite for success in treatment.
If you were to study the etiology of eating disorders, you would see that a definitive cause has not been determined. Thus, a more realistic approach to treatment is replacing dangerous and maladaptive behaviors with those that do not involve self-harm. You can do that with counseling. It sounds like you are on the right track. Good luck. Please take care.
Dr. Kristina Randle