To describe the management of a woman with cerebral palsy and anorexia nervosa. We carried out a literature search and gained consent and a history from the patient. We explored the etiological and ethical issues raised in this case. Etiological issues are raised, looking at the interaction between physical disability and self-image. Clinical and practical difficulties of caring for a patient with physical disability properly on an eating disorder unit are discussed, as well as ethical issues concerning mental capacity and the use of the mental health act in anorexia nervosa. This case reminds us again that we can learn much from listening to patients. In this instance, service and operational policies on managing disabilities on the unit, were shaped by her input.