Eating disorders may involve dieting and eating, but the underlying problems causing the disorders aren't about food. Instead, food and dieting become substitutes for dealing with life's stresses and other emotional issues. Talking about one's problems through counseling is a successful way to begin treatment.

There are many ways to approach counseling. Multidisciplinary intervention programs offering individual and family or group counseling, as well as adjunct self-help or support groups, can help significant numbers of sufferers. The most successful program combines individual with family counseling and uses a team approach that includes a physician and nutritionist. Chemical-dependency programs often provide useful models. The core elements of the three types of counseling programs are individual, family and group counseling.

Individual Counseling

Individual counseling involves keeping a journal, using nutritional intervention, altering antecedent events, using cognitive-behavioral techniques, manipulating consequences and eliciting the support of family and friends.

Family Counseling

Family counseling involves discussing realistically how the disorder affects each member, designing tasks to fit the developmental level of each member, providing alternate ways to respond to the illness, establishing rules of eating conduct to clarify areas of control and responsibility, helping members meet one another's emotional needs and looking for abusive or addictive patterns in other members.