Probably the biggest thing that keeps people from going to doctors—all types of doctors—is fear of what they’ll find out. If we know something’s not right but aren’t sure what it is, we’re especially worried about receiving that worst-case scenario diagnosis. So we put off the visit.
This same dynamic keeps too many people from seeking treatment for an eating behavior issue. They fear the worst—namely that they do in fact have an eating disorder.
But here’s the thing: Getting that ED diagnosis may in fact be the best-case scenario. It means you’re going to get the help you need and deserve. No more hiding, nor more trying to figure things out on your own, no more sleepless nights wondering what’s going on.
Finally, you’ll have someone in your corner who is going to help you get better.
Reality check: Before showing you how to find that provider, here’s something important to know that may inform your visits with your doctor or therapist. Which is this: Most medical professionals don’t have a lot of experience with eating disorders.
We don’t mean to disparage providers in saying this, and it’s certainly not meant to put you off of seeing one. It’s simply the reality, and it’s important to know. There aren’t nearly enough qualified eating disorder specialists to cover the need.
What can you do about that? Some due diligence can help a lot.
Step 1: Questions to ask when considering a doctor or therapist
If you don’t think you’ll have time for all these questions, pick four or five that are most important to you. Then send them to the provider before your appointment, or ask them at the beginning of your visit.
- What is your experience and how long have you been treating eating disorders?
- How would you describe your treatment style?
- How often will I see you?
- How do you treat coexisting mental health conditions such as depression or anxiety?
- Will I need a medical evaluation before my treatment begins?
- How will you involve my family members or friends?
- What insurance, if any, do you take? Are there other payment plans I can use?
- Approximately how long will the treatment process take? When will we know it’s time to stop treatment?
If your prospective provider doesn’t give you the time of day with these questions, or if you’re not happy with the answers, look for someone else. There’s a better match for you.
Important note: Some people are hesitant to question a provider like this (above). Or maybe doing so just feels like another barrier to treatment you’d rather not bother with. We get that. If that’s how you feel, save the vetting for later, as it’s important to get your care started. Just be ready to make adjustments as you move forward.
Step 2: Talking to your provider about your eating disorder
Make no mistake, you are the most important member of your treatment team, so do your best to take a an active, honest, positive role in your care. A few things about that initial visit.
First, it’s best to bring a trusted family member or friend along with you for support, at least on the first visit, and have that person with you when you meet with the provider. Second, write down everything you want to say before your visit, including the questions you have, then either print them out or have them handy on your phone. This will be your “script,” or cheat sheet, for the visit, which is important. People tend to go blank at times like this.
Third, expect to get nervous or emotional, especially at the beginning of your appointment. Totally normal! These things can be hard to talk about, and they’re personal. Just pause if you need to, grab a Kleenex, and keep pushing through with your script (it’s easier to read something than to try and remember it).
Finally, be honest in what you say, even regarding the embarrassing parts. There’s no need to sugarcoat anything. That’s the only way you’ll get an accurate diagnosis—and a successful treatment plan.
Step 3: Creating a script for your appointment
Your answers to the following will give you the content you’ll want to cover. Again, write all this down.
- What are the eating behaviors that are concerning you the most? (Be as specific as possible.)
- How long has this been going on?
- How do you feel about yourself these days? (Again, try to be specific.)
- Has your eating behavior affected your ability to work or do schoolwork?
- Are you avoiding certain activities you used to enjoy because of your eating behaviors?
- Have you noticed any physical symptoms lately that weren’t present before, such as extreme fatigue, anxiety, dizziness or difficulty concentrating, social withdrawal, or sleep problems? Others?
- Have you noticed any behavioral or emotional symptoms such as extreme mood swings, obsession with weight or calorie intake, frequent dieting, concern with body size or image? Others?
- Complete the following sentences:
- “I’ve been having a lot of difficult thoughts like ___.”
- “I do things like ____ and I’ve been doing this approximately ___ times per day/week/month.”
- Any other details you would like to include?
Step 4: What to ask the doctor/therapist after going through your script
Questions are always good, and your provider will expect and appreciate them. Consider the following:
- What is your diagnosis?
- What treatment plan do you recommend, and what are my next steps?
- Do I need a physical exam or any tests to confirm my diagnosis, or to check for complications of my condition?
- Will you or someone else conduct my treatment? If it’s someone else, does that person work for you or will this be a referral? Who will supervise my treatment?
- What other professionals will you be collaborating with for my treatment?
- What are the benefits and the risks associated with the recommended treatment?
- What will be the sequence of treatment strategies?
- Are there any physical complications of the eating disorder that need to be treated?
- Are there any associated psychiatric disorders that will need to be treated?
- Where can I get more information about my eating disorder?
Step 5 (if needed): Three provider comments to push back on
As mentioned earlier, many doctors and therapists have little experience with eating disorders, and even those who do will sometimes miss the boat with your diagnosis or treatment. Below are three comments you might hear that would be red flags that the provider may not be right for you.
Provider comment: “What you’re experiencing hasn’t been going on that long, so you’re probably fine.”
Your strategy: If the provider says this, you likely need a referral ASAP! The sooner your eating disorder is treated, the better your chance of recovery.
Provider comment: “Your current weight makes me think you don’t need a referral.”
Your strategy: Run for the door. This is a statement of ignorance and weight stigma that only makes eating concerns worse. It is impossible for a provider to accurately diagnose an eating disorder using a person’s weight alone, either by eyeballing you or via a weight scale.
Provider comment: “This may just be a phase you’re going through. Try hard to eat normally and come back in two weeks.”
Your strategy: Again, this scenario begs for a quick referral to another provider, as it shows a lack of understanding about eating disorders.
As with any important meeting, presentation, or job interview, it makes a huge difference if you know you prepared well for it. That’s what this guide is all about—to get you ready for your provider visit.
It’s going to help you arrive at your appointment calm, cool, and ready to start discovering what you need to do to get better.