Can a Primary Care Physician Treat Your Eating Disorder? Understanding the Role of PCPs in Eating Disorder Care
Can a Primary Care Physician Treat Your Eating Disorder?
Understanding the Role of PCPs in Eating Disorder Care
If you're struggling with an eating disorder — or suspect you might be — your first instinct may be to talk to your primary care physician (PCP). That’s a logical and often necessary first step. But can a PCP fully treat an eating disorder?
The short answer is: not alone, but they play a critical role. Eating disorders are complex mental and physical illnesses that typically require a multidisciplinary team, and a PCP is often the gateway to that care.
This post breaks down what your PCP can do, what they can’t do alone, and how they can support your recovery as part of a broader treatment team.
What a Primary Care Physician Can Do
1. Identify Early Warning Signs
PCPs are often the first to spot signs of disordered eating or nutritional deficiency, especially when a patient comes in for unrelated concerns like fatigue, irregular periods, gastrointestinal issues, or anxiety.
They can screen for:
Rapid weight loss or weight fluctuation
Bradycardia (low heart rate) or hypotension
Amenorrhea (missed periods)
GI symptoms (bloating, constipation)
Malnutrition and vitamin deficiencies
Dehydration or electrolyte imbalances
PCPs can use screening tools such as the SCOFF questionnaire or Eating Disorder Screen for Primary Care (ESP).
2. Monitor Medical Stability
Eating disorders can lead to serious and even life-threatening complications, especially in adolescents and those with restrictive behaviors. A PCP can:
Order labs (CBC, CMP, thyroid panel, electrolytes, liver enzymes, etc.)
Monitor vital signs, EKG, and bone health
Track weight trends and growth curves in youth
Identify when a patient is medically unstable and needs urgent intervention
According to guidelines from the Society for Adolescent Health and Medicine (Golden et al., 2015), medical monitoring is an essential component of eating disorder treatment — and PCPs are well positioned to do this.
3. Refer to the Appropriate Specialists
Because eating disorders are both mental and physical illnesses, PCPs are usually not equipped to treat them alone — but they can initiate referrals to:
Therapists or psychologists trained in eating disorder treatment
Registered dietitians with experience in eating disorders
Psychiatrists (especially if medication is needed)
Specialized treatment programs (IOP, PHP, residential, or inpatient care)
Adolescent medicine or internal medicine specialists for complex cases
A good PCP understands the limits of their scope and helps build a collaborative care team.
4. Offer Compassionate, Ongoing Support
Even when care is led by specialists, your PCP can still:
Provide continuity between levels of care
Support you in managing other health concerns
Advocate for insurance approvals and treatment coverage
Validate your experience and offer encouragement
Track medical progress throughout recovery
In many cases, especially where access to specialized care is limited, a PCP may coordinate care alongside other providers — and that ongoing relationship matters.
What a PCP Cannot Do Alone
Despite their essential role, PCPs are not a replacement for specialized care when it comes to treating an eating disorder. They typically cannot:
Provide psychotherapy (e.g., CBT-E, FBT, DBT)
Offer nutritional counseling tailored to disordered eating
Safely manage refeeding in high-risk cases
Address the underlying psychological drivers of the disorder
Monitor behavioral symptoms like bingeing, purging, or compulsive exercise
Eating disorders often require intensive and coordinated intervention that goes beyond what a typical primary care visit can provide.
What If a PCP Doesn’t Understand Eating Disorders?
Unfortunately, not all PCPs receive extensive training in eating disorders — especially in recognizing non-stereotypical presentations, such as:
People in larger bodies with restrictive eating
Males, nonbinary, or transgender individuals
Individuals with ARFID, orthorexia, or OSFED
High-functioning individuals with hidden symptoms
If your concerns are dismissed, minimized, or misunderstood:
Advocate for yourself: “I’m concerned about my relationship with food and body image. I’d like a referral.”
Bring data: Mention physical symptoms, mood changes, or any screening tools you’ve completed.
Bring a support person if needed.
Seek a second opinion or ask for a referral to a specialist.
When to See a PCP Immediately
You should contact your PCP (or go to urgent care) if you’re experiencing:
Fainting or dizziness
Rapid heart rate or chest pain
Severe gastrointestinal distress
Inability to keep down food or fluids
Confusion, extreme fatigue, or weakness
Signs of electrolyte imbalance (muscle cramps, tingling, seizures)
Eating disorders can become medical emergencies — and your PCP is often your first line of defense.
Final Thought
Your primary care physician cannot treat your eating disorder alone — but they can be one of your strongest allies in recovery. They can catch warning signs, ensure your physical safety, connect you to specialized care, and walk alongside you as part of your support team.
If you're struggling, don't wait until it's severe to speak up. Your life and well-being are worth the attention — and your PCP may be the first person who helps you take that critical step toward healing.
