Exposure therapy is widely recognized as an effective psychological treatment for OCD but it is not successful in every case. Poorly executed exposure techniques could be implicated. Negative perceptions contribute to poor execution, pitfalls, or the underutilization of this therapy altogether. This, along with common ED misconceptions that are cultural and disorder-specific, can also result in poor treatment for those with EDs. It is important that the therapist has a thorough understanding of the patient’s presentation to ensure that exposures target the precise core fear for new learning. Lack of understanding can lead to mistakes and missed opportunities to enhance exposure, such as failing to explain the rationale, reducing safety behaviors, or overusing a hierarchy. An inexperienced therapist may not understand the importance of discussing the role of family and friends and how their accommodation can perpetuate symptoms, hindering new learning and preventing lasting change. The therapist should be able to identify the core fear, triggers, and avoidance behaviors in the patient and use strategies to enhance inhibitory learning and maximize the chances of successful treatment.

After gathering important information during the assessment process, clinicians can begin working with their patients to collaboratively develop a conceptualization of the patient’s disorder. This early phase of treatment provides an opportunity for clinicians to educate patients about their disorders, including the complex nature of comorbid OCD and EDs, and obtain informed consent for treatment. Informed consent is essential as it ensures that patients understand the treatment options, their potential risks and benefits, and the uncertainty surrounding the best course of treatment for this comorbidity. A functional analysis, which assesses the purpose and function of the patient’s behaviors, can provide valuable data for creating a treatment plan. By understanding the root and function of the patient’s behaviors, it will be possible to prioritize treatment and develop a promising treatment plan. Additionally, it is crucial for clinicians to assess the impact of malnutrition or weight loss on the patient, as this will inform treatment planning and may affect the course of treatment.