Abstract: Eating disorders represent a complex spectrum of chronic illnesses, with medical and psychologic complications that lead to the highest mortality of all psychiatric disorders. Likely rates of morbidity and mortality are even higher than reported for women with these conditions because patients often deny or are secretive about the extent of their fasting, binge-eating, and purging behaviors. Early detection and treatment are critical, and obstetrician-gynecologists are in an ideal position to identify these disorders, which primarily affect women. A variety of biologic, psychologic, social, and cultural factors underlie the development of eating disorders and influence treatment. Although these illnesses are most commonly seen in adolescents and young adults, clinicians also must be aware of the unique ramifications in athletes and patients who have diabetes mellitus, are pregnant, and are middle aged. Obstetrician-gynecologists are essential members of a multidisciplinary team that treats the medical, nutritional, and psychologic needs of women with eating disorders. Nutritional and psychotherapeutic interventions remain key to recovery, despite the growing understanding of the genetic and neurochemical underpinnings of these illnesses. Effective management requires attention to the appropriate level of care, an understanding of basic psychotherapy concepts and modalities, and ongoing medication management in order to reverse what can become a chronic problem.