Top 10 Things a Medical Provider Should Know About Eating Disorders: From a Patient's Perspective
by Dr. Patrice Lockhart, MD
Eating disorders are complex, life-threatening conditions that often go unrecognized or are minimized in medical settings. Many patients report feeling dismissed, misunderstood, or even praised for behaviors that are actively harming them. From a patient’s perspective, these experiences can delay care, increase shame, and make it harder to be honest with providers.
This list reflects common themes shared by patients navigating medical care while struggling with eating disorders. These insights are offered not as criticism, but as an invitation for providers to reflect, learn, and strengthen the care they offer.
10. Don't judge a patient by their size. Think function, not form.
Eating disorders occur in bodies of all sizes. Weight alone tells you very little about a patient’s medical or psychological risk. Focusing on physical appearance can lead to missed diagnoses, especially for patients in “normal” or higher-weight bodies. Functional markers, vital signs, behaviors, cognition, and energy, are far more reliable indicators of health.
9. If a patient's family is worried about weight change, listen.
Families often notice subtle but important changes long before labs or vitals flag concern. Dismissing family worries can unintentionally delay intervention. Taking these concerns seriously can provide critical context and support earlier, more effective care.
8. "You look great! You've lost weight!" is a sure way to encourage eating disordered behaviors.
What may feel like a harmless compliment can reinforce restriction, purging, or compulsive exercise. Many patients report that praise for weight loss strengthened their eating disorder voice and made recovery feel unsafe. Neutral, health-focused language is essential.
7. Recognize how your own biases toward weight impact care.
Implicit bias toward thinness and weight loss is deeply ingrained in medical culture. Patients who feel judged or treated differently because of their size are far less likely to disclose symptoms honestly. Self-reflection and bias awareness are critical components of ethical care.
6. Do not assume that if lab values are normal, a patient's health is "fine."
Eating disorders often exist long before lab abnormalities appear. Vital signs, menstrual changes, dizziness, fatigue, and, most importantly, behaviors such as restriction, binge eating, and purging provide essential clinical information. Labs are one piece of a much larger picture.
5. Purging is not just vomiting.
Purging behaviors include misuse of laxatives, diuretics, diet pills, insulin, and compulsive exercise. Many patients do not identify these behaviors as purging and may not disclose them unless specifically asked in a nonjudgmental way.
4. 1 out of 3 patients with eating disorders does not get the help they need. Intervene early to make a difference.
Eating disorders have one of the highest mortality rates of any mental health condition. Early recognition and intervention can be lifesaving. When in doubt, err on the side of taking concerns seriously and initiating support.
3. If a patient presents to you for medical treatment of an eating disorder, see them often.
Regular follow-up communicates that you take the patient’s condition seriously. Infrequent visits can feel dismissive and may allow medical instability or dangerous behaviors to escalate unnoticed.
2. If there is no progress in a patient's well-being, refer to a higher level of care quickly.
It is not adequate care to allow a patient to continue engaging in dangerous behaviors without escalation. Early referral to specialized treatment can prevent medical complications and reduce long-term harm.
1. Screen for eating disorders routinely.
Eating disorder screening should be as standard as screening for substance use or sexual health. Cultural pressure around food, weight, and appearance is pervasive, and many patients will not volunteer concerns unless asked directly.
Most patients do not expect perfection from their medical providers. What they hope for is curiosity, humility, and willingness to listen. Small shifts in language, awareness, and screening practices can make a profound difference in whether someone feels seen, and whether they get the care they need.