**Author details**

through a purely behavioral lens, first responders who fail to investigate and probe an underlying emotional landscape are likely to recommend a non-integrative solution, such as dieting, missing the opportunity to address the full complement of impinging psychological, neurobiological, and neurophysiological factors that contribute to weight management dysfunctions. Dieting, and particularly the use of unhealthful weight control behaviors, increase risk for weight gain and later eating-

It is through a unique use of self within the diagnostic moment that the knowledgeable and informed first responder approaches the uniquely challenging arena of weight management. By "listening with a third ear," the clinician with clear intention and exquisite sensitivity to implied and unspoken issues intuits and then skillfully addresses the possibility of a yet unknown and unnamed condition as part of a wider constellation of symptoms. The proactive diagnostician fosters the patient's self-reflection, self-acceptance, and incentive to heal dysfunctions sustainably at their source; increased self-esteem and positive body image have been shown to be best achieved through self-acceptance rather than weight reduction [41]. Research justifies the need for long-term implementation of interventions that aim to simultaneously prevent the onset of obesity and ED through the prevention of dieting behaviors and the promotion of healthful eating and physical activity as ongoing lifestyle behaviors [21]. Research reveals that fitness center employees, ideally placed to observe clients who exhibit an addiction-like relationship with exercise in an effort to lose weight as part of an ED, require detailed guidelines for intervention, including ways to start conversations to this end [42]. Bottom line, first responders need to determine whether the patient's desire for weight change is based on healthful choices and discretion, or on the dictates of pathological compulsions that underlie and drive dysfunctional eating behaviors. In either case, the diagnostician sets the stage for the patient's immediate and compelling engagement in integrative treatment, creating the potential to save lives and promote life quality.

Heartfelt thanks, love, and gratitude to my husband Lou, who edited this chap-

and weight-related problems [21].

*Weight Management*

**Acknowledgments/Thanks**

ter with devotion and enthusiasm.

**Acronyms and abbreviations**

BED binge eating disorder

DE disordered eating

**174**

The authors declare no conflict of interest.

ED eating disorders, eating disordered

OCD obsessive-compulsive disorder

SPD sensory processing disorder PTSD posttraumatic stress disorder RRT rapid resolution therapy

OSFED other specified feeding or eating disorder EDNOS eating disorder not otherwise specified

ARFID avoidant restrictive food intake disorder

**Conflict of interest**

Abigail H. Natenshon Eating Disorder Specialists of Illinois: A Clinic Without Walls, Highland Park, Illinois, United States

\*Address all correspondence to: abigailnatenshon@gmail.com

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
