Perhaps you've decided that you should get treatment for an eating disorder. Or you want to have a professional tell you whether you have one or not. But you're concerned because you don't know what happens in the evaluation process.
Here are some things you can expect to happen in medical and psychological evaluations when you begin (or consider) treatment.
Preparation for Eating Disorder Treatment
As with any treatment-oriented process, there is quite a bit of paperwork in eating disorder evaluation. Whether you begin by seeing a doctor, a psychiatrist, a counselor, or another professional, you may be asked to sign several releases of information.
Your conversations with your treatment providers are confidential, so these documents are used to allow your providers to speak with each other and coordinate your care. Also, if your family is going to be involved, you may want to sign one or more releases of information so that your providers can speak with them.
This is not easy to do when you don't want anyone to know about what's happening. But it's usually the best course of action, since you need the best support you can have for recovery.
Eating Disorders and Medical Evaluation
A thorough evaluation will include a medical exam. If you start by seeing a counselor, for example, the counselor should refer you to a doctor. Expect the doctor to take your vital signs, of course, and your height and weight (this happens in almost any doctor's appointment). You will be checked for appropriate physical growth and development.
The doctor will likely check you for signs of dehydration, since eating disorders often leave the body drained of water. Expect your heart to be checked (especially since heart failure is a frequent cause of death in advanced anorexia). It is common to take a blood sample to get information about whether your body's internal systems are working normally.
If you purge, you may be referred to a dentist to have your teeth evaluated for damage from stomach acid.
Psychological Evaluation
If you don't start by seeing a counselor or psychiatrist, your doctor will probably refer you to one. This person will gather a history of your disordered eating and any treatment that you have received in the past. It is common to provide a report of what you eat in a day (or several days). In some cases, the clinician may observe your eating directly.
You can expect to hear questions about how you view your body and what your attitudes are toward eating. Your mood and anxiety level will be evaluated, since these can fuel eating disorders, and vice versa.
A good interview will also explore any stressors that trigger disordered eating or magnify the effects of the disorder. You will probably be asked about problems that have come up in past relationships. In some cases, a counselor will ask about different kinds of abuse that you may have experienced.
The Next Step
Providers will base their treatment choices on the results of these evaluations. Treatment may involve changes to your diet, counseling, medications, and medical checks. It may occur in an outpatient setting or an inpatient treatment center, depending on the severity of your symptoms.
One hard part of many treatment plans is managing relationships with family and friends. These persons may not understand why the eating disorder is present, which will likely make you feel misunderstood. However, many treatment programs include education and help for loved ones. This can help to bridge the gap.
Making a Move
Picking up the phone and calling a treatment provider is not easy. Even considering it can feel very dangerous, since treatment means that your life will change. Knowing what may happen can reduce your anxiety about starting treatment and give you a head start toward recovery.
ReferenceAmerican Psychiatric Association. Treating Eating Disorders: A Quick Reference Guide. Accessed 9 October 2006.
