Managing eating disorders in outpatient therapy: Clinical tools and best practices

Eating disorders encountered in outpatient practice span a broad spectrum: anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID), and other specified feeding or eating disorders (OSFED). Eating disorders rank among the most lethal psychiatric conditions with an estimated prevalence of 6 to 8% among adolescents, though are often undetected or overlooked in outpatient settings (Galmiche et al., 2019). In a society that normalizes and celebrates weight loss, “atypical” anorexia (i.e., when a patient meets the cognitive and behavioral criteria for anorexia but is not technically considered underweight) may result in weight loss being praised rather than recognized as a symptom of a serous eating disorder. It is important to recognize that weight is an unreliable indicator of severity, and a patient need not appear emaciated to be in genuine medical danger. Rather, eating disorders are multisystem illnesses with far‐reaching medical consequences that extend well beyond changes in weight or eating behaviors.