The role of an eating disorder psychiatrist

Eating disorders are serious health conditions that affect your mental and physical health. Managing an eating disorder isn’t always easy, and most people need professional help to heal. If you’re struggling with an eating disorder, think about meeting with a psychiatrist who specializes in treating eating disorders. Psychiatrists can diagnose and treat eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. 

When to see a psychiatrist for an eating disorder diagnosis

Eating disorders affect people’s eating behaviors and attitudes toward food. They can cause emotional distress and physical symptoms like brittle nails, thinning hair, and low blood pressure.

Eating disorders aren’t always easy to recognize, but some possible signs include: 

• Following a rigid eating routine

• Skipping meals, eating alone, or refusing to eat with other people

• Finding recipes or preparing food for others but not eating it yourself

• Refusing to eat anything with too many calories 

• Becoming overly interested in other people’s eating habits

• Negative body image or distress about your body or appearance

• Spending more time alone and less time with friends and family 

If this sounds familiar, it’s important to meet with a mental health professional for an accurate diagnosis. This could be a psychiatrist, therapist, psychologist, or primary care doctor. Meeting with a psychiatrist may be a good place to start if you have another mental health condition or are experiencing severe distress. 

Some of the most common eating disorders that psychiatrists treat include:

• Anorexia nervosa: Anorexia involves an intense fear of gaining weight and, oftentimes, a distorted body image. People with anorexia severely limit food intake, may eat small amounts of certain foods, or avoid food altogether.

• Bulimia nervosa: People with bulimia eat large amounts of food in a short period of time, called bingeing. They try to avoid gaining weight with behaviors like throwing up or extreme exercise.

• Binge eating disorder (BED): Binge eating disorder also involves frequent binge–eating large amounts of food in a short period of time, with a feeling that you don’t have control over the behavior during the binge. You might practice periods of dieting with this disorder, but it doesn’t involve the extreme behaviors to prevent weight gain as in bulimia. 

What can psychiatrists do for eating disorders?

A psychiatrist can be an essential part of your care team. It’s common for someone with an eating disorder to have another mental health condition, like depression, anxiety, bipolar disorder, borderline personality disorder (BPD), and post-traumatic stress disorder (PTSD). These conditions can contribute to the development of an eating disorder, or be the result of years of struggling with disordered eating.

Research suggests that someone in the U.S. dies from an eating disorder every 52 minutes. When treating an eating disorder, a psychiatrist will also help identify any life-threatening symptoms. This includes suicidal thoughts and behaviors, as well as the serious physical consequences of eating disorders.*   

When working with a psychiatrist, treatment may include:

• Psychiatric medication: Psychiatrists prescribe and monitor medication to manage symptoms and co-occurring conditions. Some medications are approved to directly treat eating disorders, and others used to help manage other severe mental health symptoms that may be getting in the way of recovery.

• Talk therapy: Psychiatrists can provide talk therapy or refer you to a provider who does. Talk therapy can help you challenge negative thoughts, improve your self-esteem, and develop healthy coping skills. 

• Collaboration: Psychiatrists often work alongside other professionals, like your primary care provider and registered dietitians who specialize in eating disorders. They may refer you to a residential or intensive outpatient program specializing in eating disorders, or a support group or online community. Depending on your symptoms and their severity, you may need other medical support. For example, self-induced vomiting over time can cause an irregular heartbeat and damage to your digestive system.

*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. If you’re experiencing a life-threatening emergency or you need immediate help, please call 911. 

Choosing a psychiatric provider for eating disorders

The sooner you get help for an eating disorder, the greater your chances of recovery. If you’re looking for a psychiatrist, consider these questions: 

• Do they have experience treating your condition? Look for a psychiatrist who has experience with eating disorders. You may even want to find someone who specializes in your disorder. 

• How do they work with other providers? Eating disorders require a collaborative approach to care. Ask how they work with other providers to help you meet your goals. This includes therapists and nutritionists.

• What services do they offer? Some psychiatrists focus on medication management, while others also offer therapy. Therapy is an important part of care, so this may influence your decision. 

• Does their personality work with yours? It's important to find a psychiatrist you feel comfortable with. You may feel more at ease with someone who has a similar personality or cultural identity. 

• What’s their availability? Once you find a psychiatrist, ask if they’re taking new clients and when you can start treatment. If you prefer morning or afternoon sessions, you may also want to ask about timing. 

Clinican's take

A common misconception about eating disorders is that people who are at a ‘normal’ body weight can’t have an eating disorder. In fact, people of all body sizes can suffer from the mental and physical health consequences of disordered eating behaviors. Talking to a psychiatric provider can help you get started on your journey to health.

Stephanie J Reed, MSW, MSN, PMHNP-BC

Clinical reviewer

Find care with Rula

Recovering from an eating disorder is possible with access to the right treatment and support. Psychiatrists often work with therapists, nutritionists, and other providers to help people improve their mental, physical, and emotional health. If you think you’d benefit from professional support, consider reaching out to a psychiatrist today.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.