Eating Disorder Treatment & Eating Disorder Therapies

The severity of the eating disorder and any co-occurring disorders will determine the initial treatment level you or your loved one should pursue. However, beginning with outpatient care is typical.

Health professionals working in outpatient centers can determine if a higher level of care is needed for specific eating disorders and refer them as necessary.

The following are the typical levels and types of eating disorder treatment:

Levels & Types of Treatment for Eating Disorders

Different treatments are available depending on your specific situation and eating disorder. Eating disorders treated at these levels include everything from anorexia nervosa to binge eating disorder.

Outpatient Eating Disorders Treatment

This treatment is the least restrictive level of care for those with eating disorders. As part of an outpatient program, you may see a nutritionist, therapist, and other recovery professionals approximately two to three times per week.

This level of care can be helpful if you need to continue to work or attend school. Outpatient treatment is also desirable if you do not have the right health insurance to cover higher levels of care but are looking for assistance to stay in recovery.

Intensive Outpatient Program (IOP) Eating Disorders Treatment

IOP is designed for people who need more support than outpatient treatment but still have some flexibility to remain working or in school.

Programs at this level usually meet several times a week with each patient, ranging from two to five days a week.

Treatment options typically include:

  • Individualized therapy
  • Personalized nutrition consultation
  • Topic-focused groups
  • Family support groups

Residential Eating Disorders Treatment

At this level of care, you are provided 24-hour care at a live-in facility. Every patient is constantly supervised, making monitoring health conditions resulting from eating disorders practical.

These treatment programs are usually very structured, offering a setting that allows you to focus solely on physical and psychological healing. In addition, everything needed is provided in one central location.

Inpatient/Hospital Eating Disorder Treatment

This level of treatment offers a continuum of care 24 hours a day in a hospital setting. The primary focus of this level of care is medical stabilization and interruption of weight loss, with typical stays of less than three weeks.

Once you’re considered medically stable, you are usually discharged to a residential treatment center for ongoing care. Find the right eating disorder treatment center in our directory.

Partial Hospitalization

Partial hospitalization programs (PHPs) are a step down from inpatient or residential treatment. Instead of receiving full-time (24-hour) care in a hospital setting, you attend PHP treatment in a structured environment for several hours a day on multiple days of the week.

This is best for those who still need significant support from staff but are medically and mentally stable enough to begin transitioning back into their normal routines.

Continuing Care

After discharge from residential and/or inpatient programs, you can continue care. This allows you to continue having periodic sessions with your primary therapist and nutritionist for ongoing recovery support.

The overall treatment team determines the frequency of sessions at the higher level of care and before discharge.

Additional Treatment Resources

Further treatment resources available to those with eating disorders include support groups or self-help options.

Support groups that meet weekly or bimonthly are great ways to stay connected to other individuals who can empathize and help with accountability. Self-help tools include journal-keeping, meal plan templates, and online recovery support.

How to Decide on the Right Eating Disorder Treatment Level

People with eating disorders aren’t passive bodies that need healing. They are personalities that deserve dignity, compassion, and choice. As someone with an eating disorder, you have a say in what treatment level is right for you.

Your treatment team will help you make a good decision, but these guidelines from the National Eating Disorders Association may help: [1]

  • Intensive outpatient: This form of care is best for medically and psychiatrically stable people.
  • Partial hospitalization: This form of eating disorder care is best for those who are medically stable but still functionally impaired and in need of daily care. Partial hospitalization is also helpful for people engaging in daily disordered eating, such as purging or fasting.
  • Residential: This form of care is best for people who are medically stable but psychiatrically impaired and need more than outpatient care can provide.
  • Inpatient: This form of care is best for those with mental and physical health conditions that must be monitored closely.

Be honest with your treatment team about how you’re thinking, feeling, and reacting. If they offer a form of care that makes you uncomfortable, explain why a different option might be better for you.

But remember that your team is qualified to make good decisions on your behalf. Eating disorders can change how you think and react. If you’re not sure which mode of treatment is best, let your team guide you.

Outpatient Treatment

Major Types of Therapies for Eating Disorders

A significant part of treating eating disorders is therapy. It’s essential to focus on mental and physical health conditions, why eating disorders occurred in the first place, and to retrain the mind for a full recovery.

Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy that focuses on negative patterns of thinking and beliefs that contribute to these thought patterns. CBT teaches you skills to identify problematic ideas and healthy ways to cope with emotions.

CBT has been shown to effectively help those struggling with eating disorders or mood disorders and decrease destructive behaviors. CBT may include:

  • Educational components
  • The development of a meal plan
  • Addressing various eating disorder facets, such as familial, psychological, and societal factors

Medical Nutrition Therapy (MNT)

MNT is a holistic method for treating various medical conditions and their associated symptoms. Customized meal plans formulated by a registered dietitian are part of MNT.

Components of MNT include:

  • Assessment
  • Dietary modification
  • Patient education

MNT is used to help establish normal eating behaviors and improve one’s relationship with food and the body.

Dialectical Behavior Therapy (DBT)

DBT is a form of psychotherapy that connects cognitive and behavioral methods to cope with painful emotions. The focus of this therapy is usually on individuals who react to emotional circumstances with extreme behaviors.

Components of DBT include the practice of mindfulness as well as emotional regulation. Although DBT was originally designed for those with borderline personality disorder, it has become an effective treatment therapy for those dealing with emotional instability.

DBT techniques can benefit eating disorder treatment because they allow individuals to better deal with conflict and stress while gaining increased control over negative thoughts and emotions.

Acceptance & Commitment Therapy (ACT)

ACT is used to help people concentrate on ways to become aware of and accept their emotions and experiences. This therapy is beneficial in eating disorder recovery, as it helps individuals develop a healthier relationship with their emotions and intellect.

ACT can help sufferers with eating disorders recognize thoughts and urges tied to the illness, assisting them in understanding these impulses. ACT also effectively treats co-occurring disorders, such as depression or anxiety.

Art Therapy

This form of psychotherapy uses art media as its primary form of communication and therapeutic healing. Patients who utilize art therapy in treatment are often guided by a professional in illustrating personal stories, thoughts, and/or feelings. Types of art therapy used include:

  • Painting
  • Clay making
  • Sculpting
  • Drawing

Art therapy can be an essential part of treatment for those who suffer from eating disorders, as it allows a creative outlet for expression and healing. Art therapy can also help treat co-occurring conditions, such as substance abuse or mood disorders.

Dance Movement Therapy

Dance therapy is a therapeutic form of healing that allows participants to become involved in an alternate way of coping and expressing emotion. Dance therapy can also play a part in achieving a healthy balance and an approach to self-expression. Movement is the leading way dance therapists observe, evaluate, and apply various interventions.

Dance therapy has been proven an effective form of psychotherapy for various disorders, including learning disabilities and mood disorders. It can be influential in healing through guided movements and expressions.

Equine Therapy

Equine therapy is a form of psychotherapy that uses horses as a tool for emotional growth. Equine therapy is based on the premise that the bond that can grow between humans and animals will allow for emotional healing to occur. Activities might include caring for and grooming the animal and basic exercises guided by a horse specialist.

Patients recovering from eating disorders who use equine therapy during treatment might have increased self-esteem and body image, particularly as caring for an animal can be an empowering experience.

Exposure & Response Prevention Therapy (ERP)

ERP is essential in helping individuals overcome fears and anxiety. This is accomplished by gradually exposing someone to the feared object or circumstance to desensitize fears.

Additionally, ERP also focuses on assisting participants in resisting compulsive behaviors that they might typically use to cope with feelings of fear or anxiety. The primary goal is for individuals to remain connected to the trigger without using their ritualistic behaviors.

ERP can effectively treat eating disorders as it helps participants overcome fears of forbidden foods and decrease urges to binge and purge.

Family Therapy

Family therapy is integral to treatment because it involves and works with families and couples. Family therapy promotes nurturing change and maturation, and a family therapist oversees sessions.

Family therapy should be considered when a malfunction is observed within a family, contributing to problems that concern the overall ability of the family to function. This therapy is crucial to those suffering from eating disorders because it promotes healing for the entire family and can help eliminate life-threatening situations.

Interpersonal Psychotherapy (IPT)

IPT is a form of therapy that focuses on managing interpersonal problem areas, such as unresolved grief, role disputes, role transitions, and interpersonal deficits. Patients who participate in this form of psychotherapy address underlying personal issues and learn how to cope better with anxiety under the guidance of a therapist.

IPT can increase self-esteem and body image. IPT is also helpful in addressing other disorders, such as substance abuse and bipolar disorder.

Treatment Discussions

The Maudsley Method

This family-based treatment focuses on incorporating parents in their child’s recovery from eating disorders. This includes guiding parents in helping their children eat balanced, healthy meals and preventing the use of eating disorder behaviors, such as purging or overexercising.

The Maudsley Method typically involves three stages and can be a crucial part of long-term recovery for adolescents with eating disorders.

Articles for Eating Disorders

  • Somatic Experiencing, Trauma, and Treating Eating Disorders: Physical or psychological traumas often contribute to an eating disorder’s development. Appropriately healing from these traumas is a critical aspect of the recovery process from an eating disorder.
  • Benefits of Yoga for Eating Disorder Recovery: Yoga is a therapeutic practice that can complement the recovery process from an eating disorder. Practicing yoga can reap many benefits for the person with an eating disorder, including physical healing, improved body image, and greater awareness of one’s feelings and emotions.
  • Utilizing Brain Stimulation in the Treatment of Eating Disorders:  A noninvasive magnetic brain stimulation called repetitive transcranial magnetic stimulation (RTMS) has shown some successful results in a study of 20 participants. Magnetic stimulation is performed on the frontal lobes of the brain.
  • Navigating the Rough Waters When Looking for Eating Disorder Inpatient and Residential Programs: Because of the many stigmas associated with eating disorders, it can be difficult for sufferers to seek the treatment they need. Finding the right level of care and treatment center can involve many challenges and obstacles.
  • Neurobiology and Eating Disorders: The brain has millions of neurons with trillions of connections. A substantial portion of the brain is committed to the emotions and reasoning required to acquire food, what to eat, when to eat, and how much to eat. Is it any wonder, given the complexities of the brain, that some of us develop some sort of disordered eating?
  • The Value of PHPs and IOPs: Many eating disorder treatment programs require round-the-clock medical supervision in a hospital. Some offer a more relaxed outpatient approach when symptoms are less intense, and some people need a treatment option somewhere between. This is where partial hospital programs (PHPs) or intensive outpatient programs (IOPs) provide a real service and value. These solutions afford the patient and their loved ones an intense approach to recovery without having to leave home and incur the expenses that come with that.
  • Experiencing Inpatient Treatment: Eating disorder prevalence rates continue to increase among men and women. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), the mortality rate for individuals suffering from anorexia nervosa is 12 times higher than the death rate of all causes of death for females between the ages of 15 and 24.
  • Eye Movement Desensitization and Reprocessing (EMDR) in Eating Disorder Treatment: EMDR sessions are not scary. At first, the therapist will do a lot of history-taking and tell you all about the process.

References

1. Types of Treatment. (n.d.). National Eating Disorders Association. Accessed September 2022.

Published on January 11, 2023 and Reviewed By Jacquelyn Ekern, MS, LPC.
Published on EatingDisorderHope.com