The Ideal Practices of Assessing Anorexia Nervosa and Related Health Issues

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One of the first steps of treatment for anorexia is an assessment. Here’s some things that should be included in this phase of treatment for optimal recovery.

It’s common knowledge among mental health professionals that anorexia nervosa is a serious mental health issue. While all eating disorders can cause physical and emotional harm, anorexia is one of the deadliest mental illnesses [1]. This is why it’s so important to assess properly.

What is the Assessment Process & Why Does it Matter for Treating Anorexia?

Assessment is the part of treatment where a therapist or other mental health professionals tries to figure out what is going on with someone. Assessments help clinicians figure out what someone is struggling with. After the assessment, a clinician may create a treatment plan. A treatment plan is the professional’s plan on how they are going to help someone reach their goals.

A proper assessment is directly tied to how effective the treatment can be. This is because if someone doesn’t have an accurate understanding of what’s going on with someone, they can’t have an effective plan in treating them. How can you help someone if you don’t even know what’s going on with them? You can’t.

Research currently shows that most people aren’t diagnosed with anorexia until they meet with an eating disorder specialist [2]. This is problematic because the earlier someone gets diagnosed, the sooner treatment can begin. If doctors, mental health professionals, or nutritionists are not properly trained in how to assess for this type of illness, then they are going to miss the signs that someone needs treatment for anorexia.

Assessment occurs at the beginning of treatment, but it’s an ongoing process. Assessments allow healthcare providers to monitor progress. Assessment skills can always be improved upon. Thankfully researchers have looked into this and have found several things that healthcare providers can ask about in order to strengthen their assessments [2].


When assessing someone for anorexia, there are a few key things that providers should be aware of. To do an effective assessment, you need to know more than the signs and symptoms of anorexia. Assessors should also be looking for the following:

Severity of illness

it’s important to know how to determine how severe someone’s anorexic behaviors are. This is because it directly ties into how much care they may need. It can be difficult to determine how severe someone’s eating disorder is since there isn’t a universal understanding of what “severe anorexia” looks like.

It’s common though for providers to look at how severe someone’s weight loss is or how much emotional distress the disorder is causing them [2].

Co-occurring diagnoses

Someone has co-occurring diagnoses when they have two conditions at the same time. It is common for people with anorexia to have other mental health disorders as well [1]. In fact, some studies show that about 97% of people with anorexia also have other mental health conditions [1]. This also allows providers to determine if there is any risk of self-harm or suicide.

Being able to assess other mental health symptoms is important in helping someone get the best possible care. This is because other mental health conditions can make eating disorder symptoms worse.

Family involvement

Having family members involved in the treatment process can be extremely helpful [2]. During the assessment process, family members can provide helpful information about their loved one’s eating disorder. Assessing for family involvement can also help the provider support the family. This is so that everyone in the family has what they need in order to support the person in recovery. This is especially true for adolescents who are struggling with anorexia because parents or other adult family members may have to significantly help during this time [2].


Barriers are anything that is going to make recovery harder for someone. Some examples of barriers include lack of finances or access to healthcare. Other examples could be a lack of emotional support or minimal motivation to get better [2]. Knowing what barriers someone is coming up against can help plan ahead for how to better support them. This increases the chances for optimal recovery.

Medical & Nutritional concerns

As mentioned earlier, anorexia nervosa is one of the deadliest mental illnesses. This is because of the medical complications that can come from anorexic behaviors [2]. For this reason, it’s important for the assessment process to include some type of medical and nutritional assessment. This can help providers be aware of what type of medical support they need in addition to mental health care.

While this is a lot of information to get, it all helps. If doing a thorough assessment makes the difference between someone getting life-saving care, then it’s worth it.

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[1] National Eating Disorders Association. (2018). Statistics and Research on Eating Disorders.

[2] Surgenor, L.J. & Maguire, S. (2013). Assessment of anorexia nervosa: An overview of universal issues and contextual challenges. Journal of Eating Disorders, 1(29). 1-12.

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published May 18, 2021, on
Reviewed & Approved on May 18, 2021, by Jacquelyn Ekern MS, LPC