The field of eating disorders is currently at a crossroads and faces important challenges of sustainability. These challenges include problems with the current diagnostic classification of eating disorders and the divide between scientific research and clinical practice. If riot addressed, there is a danger that the field will fail to evolve adaptively, risking increased stagnation and reduced relevance. To meet these challenges, researchers and clinicians must work toward a more holistic ecology of eating disorders based on the interaction of theory, research and practice. The present paper proposes six steps towards increased sustainability based on developing clinically relevant diagnosis, using systematic quality assurance, expanding the scope of treatment research and the definition of evidence, promoting therapist development, as well as stimulating diversity and discourse. If we rise to the occasion and face these challenges, then we will be better equipped to meet the evolving needs of clinicians, researchers, and most importantly patients. Copyright (C) 2010 John Wiley & Sons, Ltd and Eating Disorders Association.