Since 1859, when Marce described a “hypochondriacal delirium” characterized by food refusal, eating disorders have been recognized as having a psychological component (Silverman, 1997). This article examines the psychological factors inherent in anorexia nervosa and bulimia nervosa using a transactional analysis developmental perspective. The interaction between psychological and physiological factors that maintain an eating disorder is discussed, and a psychotherapeutic approach that includes the consideration of dietary advice, weight monitoring, and medical intervention is offered. With reference to case material, the author argues that ensuring adequate nutrition is compatible with the role of a transactional analysis psychotherapist.