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March 5, 2018

Is Eating Disorder Treatment Worth the Expense?

Anorexia nervosa, bulimia nervosa, and binge eating disorder are often the most well-known eating disorders. They come with varying symptoms and behaviors. Underlying issues can include low self-esteem, low self-worth, and a distorted body image.

Eating disorders are often triggered by these underlying issues as well as co-occurring mental health disorders, a childhood trauma, or family dynamics.

Other factors such as genetics, sports activities, wrestling, or cycling can create negative emotions which can also play a role in the development of an eating disorder.

Research indicates that eating disorders are the least likely to be treated, but are the number one cause of death due to a mental health disorder [1]. Leaving an eating disorder untreated can lead to severe psychological and physical problems.

Physical consequences include anemia, heart palpitations, hair and bone loss, gastrointestinal distress, and lack of menstruation.

Psychological symptoms can include emotional, mood swings, irritation, sleeping more than usual, obsession with body and food, depression, and anxiety.

Best Bang For Your Buck

Treatment can help with stopping the progression of the disease and begin recovery of the eating disorder. Treatment teams are made up of a professional therapist, psychiatrist, nutritionist, and treatment staff.

A therapist can help by focusing on health, rather than weight. Clinicians work with the individual on changing irrational thoughts and behaviors through the use of different types of therapy such as Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Acceptance Commitment Therapy, etc.

For example, Dialectical Behavioral Therapy is used to identify and engage emotions, learn to tolerate distressing situations or feelings, and improve daily functioning with one’s self and others.

Experiential therapies are also used to help with alternative ways of processing, such as yoga, art, body movement, and equine therapy.

Group therapy is an extension of treatment [1]. Interacting with those experiencing similar situations can help a person connect with others.

It allows for each person to look at their experience and disorder in a new perspective. Group therapy provides support to the sufferer outside of higher levels of care.

A therapist can also help with family therapy and education around the eating disorder. For many, family dynamics play a role in the continuation of the eating disorder.

A mediator, such as a therapist, can work with the family on psychoeducation, therapeutic interventions, and can help your loved ones learn more about how to best support you.

Nutritional support is also offered in treatment. Meeting with a nutritionist or dietician can help with meal planning, undoing irrational thoughts around food and rules.

It can aid in relearning how to listen to your body without judgment. Being able to have extra support to guide a person in learning that food is healthy is imperative in treatment.

Woman struggling with TreatmentPsychiatrists can also be part of the treatment team. They provide medicine for co-occurring disorders that may be affecting the eating disorder and quality of life.

Typically psychiatric appointments are one time per week or less, depending on the severity of the eating disorder and need of the sufferer.

Support groups are also a part of the treatment process. After higher levels of care, the person may want to continue to be a part of a group and to connect weekly with others.

Often many treatment centers offer support groups on an ongoing basis.

Levels of Care

There are various levels of care depending on a person’s need and severity of the eating disorder. The highest level is residential treatment. This level is 24-hour care, supervision, and support.

A person will live at the facility. All meals, snacks, and treatment are provided at the treatment center. Treatment is typically 30 to 90 days at this level.

As the person improves, the individual may step down to partial-hospitalization program (PHP) where all meals and snacks are provided, as well as therapy, but will go home at night.

This stage of care is from 8-12 hours per day depending on the facility. A PHP program allows the individual to practice skills learned at the residential level, still have intense care, but get to go home in the evenings. This level of care is typically for 15-30 days.

The next level of care is intensive outpatient therapy (IOP) where a person attends supportive group therapy for three hours per day up to six days per week but gets to spend the remaining hours of the day at work and home.

Most people start at six days per week and then slowly step down to three. This type of treatment normally lasts two to four weeks. Individuals are responsible for providing their meals, and staff checks the contents to ensure that it complies with the meal plan set by the facility nutritionist.

Therapy sessions, nutritional sessions, and psychiatric sessions are not included in an IOP program as it is mainly group therapy.

Lastly, a person graduates to outpatient therapy which can be from one to three times per week. Typically at this level, the focus is on any remaining issues such as body image issues, life skills, or returning to daily activities.

Care at this level typically includes continued weekly nutritional sessions and monthly to quarterly psychiatric meetings depending on need.

Outpatient therapy is ongoing and can continue for months to years. Sessions start at one time per week and can graduate to monthly and even quarterly as the person progresses in treatment.

Steps to Consider When Deciding If Treatment Is Right

Talk with a therapist to assess the severity of the eating disorder. What level of treatment is recommended? The level of treatment is a crucial factor in determining if treatment is worth the cost. The longer eating disorder patterns continue, the more ingrained they become and the more difficult it is to treat.

Seek out resources and options for payment before deciding which level with which begin. Call your insurance company to see what is covered under your benefits.

Woman with binge eating disorder seated by the riverTalk with loved ones about their thoughts and support for your recovery process. It can help to know where they stand before you start on the road to recovery.

Assess your financial ability to continue if you still need treatment after insurance runs out. Think about family contributions, financial loans or see if the program offers a sliding pay scale if treatment goes longer than anticipated.

Meet with a local treatment facility and get an assessment. Most facilities offer free assessments, and they can recommend the level of which would be best to start. They also will give tours of the program and premises so you can better decide what would be the best fit.

As a person seeks treatment and begins the recovery process, it can be a rollercoaster of success and setbacks. Seeking treatment is critical in recovering from an eating disorder. No matter the cost, you are worth every cent.


Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is an Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


References:

[1] American Psychological Association. (2008, October). Eating Disorders: Psychotherapy’s Role in Effective Treatment [Press release]. Retrieved January 12, 2018, from https://www.apa.org/practice/programs/campaign/fyi-eating.pdf


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on March 4, 2018.

Published on EatingDisorderHope.com

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