It may be difficult for someone to reach out for help as they may feel helpless, ashamed and guilty. They may also be scared to try and change.
The first major step in overcoming an eating disorder is wanting to change, understanding that eating disorders are unhealthy and then slowly building up self esteem and other ways of coping that do not include eating disorders.
During recovery, people help with the underlying issue, build self esteem, learn to manage feelings and work on the physical wellness of the patient.