Eating Disorders Hide in Plain Sight

"Here is the reality: It is very likely that clients with eating disorders are already on your caseload. They may not have disclosed it. They may not meet full diagnostic criteria. Their symptoms may be early, evolving, partially treated, or carefully concealed. Eating disorders exist on a continuum, and clients seek therapy at many different points along it. Most do not walk in asking for help with an eating disorder."

"Eating Disorders Rarely Announce Themselves In general mental health settings, eating disorder symptoms are often secondary, minimized, or entirely overlooked. Clients rarely say, "I think I have an eating disorder." Instead, they may describe chronic dieting, rigid food rules, secretive eating, compulsive exercise, intense body dissatisfaction, or cycles of restriction and overeating. Some behaviors are subtle.Some are longstanding but normalized.Some are escalating quietly."

"Clients may present with anxiety or trauma while eating disorder symptoms remain hidden. Early recognition significantly improves long-term outcomes. Routine screening and referral are core clinical competencies. Eating disorders have one of the highest mortality rates of any psychiatric illness. Yet many therapists are not thoroughly trained to assess for them. Here is the reality: It is very likely that clients with eating disorders are already on your caseload."

Eating disorders carry one of the highest mortality rates among psychiatric illnesses and often present covertly in general mental health caseloads. Symptoms frequently appear as chronic dieting, secretive eating, rigid food rules, compulsive exercise, body dissatisfaction, or cycles of restriction and bingeing, and may not meet full diagnostic criteria. Subthreshold or concealed symptoms can destabilize mood treatment, complicate trauma work, deepen shame, and increase unexplained medical risk. Therapists commonly occupy a position to detect patterns and ask direct questions about food and body image. Routine screening, early recognition, and timely referral are essential clinical competencies that improve long-term outcomes.

Read at Psychology Today