It's a good question. In my experience most people need some professional help and of those more than half need an intervention that's at a higher level of care than just seeing a counselor. For instance, in the outpatient program or an inpatient program or residential program, it is possible from the analogy that an alcoholic can stop drinking without going to AA and just kind of make this pact to not do it anymore but that's even rarer with an eating disorder. Anybody who has ever tried to diet knows pretty much what I am talking about. They wake up with the best of intentions in the morning and find by nightfall they had not been able to adhere to their commitment and likewise with an eating disorder whether its anorexia, bulimia or compulsive overeating, folks may come to a decision that they don't want to have an eating disorder any more or recognize that it is a problem and with the best of intentions make their commitment to eat properly during the day or to not binge or to eat more if they are anorectic and find by nightfall that their head is in the toilet or that they are not eating what they committed to eat or that they are overeating. So again if you look at this from an addiction standpoint, one of the demarcation points with an addiction is that you crossover a line, where you are controlling food and weight and wake up one morning and find you have crossed the line to where weight and food are controlling you and that happens with people with drug and alcohol problems. If they begin by controlling how they feel with alcohol and they cross over the line where the alcohol is now controlling them. So if someone recognizes that despite the best of intentions that they are, as they say powerless, they need to get professional help as soon as they recognize that. One of the foot notes to this addictions including eating disorders and one of the few illnesses I know of that keep telling the victim that they are not that sick, it's called denial. So, most alcoholics find that they are the last person to know that they are alcoholic. Long before they got that awareness their family and friends knew they had a problem. For someone with anorexia more than compulsive overeating or bulimia there is a greater deal of denial because the body image issues and because the sufferer usually feels good but isn't doing good. With bulimia and compulsive overeating there is less denial because very few people consider throwing up after they overeat as kind of normative behavior and for compulsive overeaters they tend to view their weight rather than their eating pattern as a problem. So with compulsive overeating you tend to wear the problem, with bulimia you are pretty much aware that something is not right and with anorexia there is a little bit more denial.
