Inpatient vs. Residential Eating Disorder Treatment: How to Determine Which is Necessary

Eating disorders are serious mental health conditions that require specialized treatment to overcome.

Yet, while all eating disorders call for professional care, the conditions occur at varying levels of severity, making different levels of treatment more appropriate for certain patients or at various points in the recovery journey.

Inpatient and residential treatment are generally both used to treat severe eating disorder cases, though the two types of treatment have important differences.

Residential vs. Inpatient Treatment

There are several levels of care for eating disorders, ranging from hospitalization, in the most severe cases, to outpatient treatment, in more controlled cases. Yet while there are clear differences among these levels, residential and inpatient treatment are often conflated or lumped together in the same category.

As such, many people don’t fully understand the differences between residential and inpatient treatment, but learning more about the two can go a long way toward making a more informed decision about which level of care is right for you or your loved one.

What Is Inpatient Treatment?

Sometimes also referred to as inpatient hospitalization, this level of care is the most intensive form of eating disorder treatment.

Patients in inpatient treatment are experiencing severe eating disorder symptoms and related mental, physical, and emotional health problems. Patients at this level of care are generally considered medically unstable and are often facing an immediate risk of death.¹

The idea behind inpatient treatment is securing these patients in a clinical setting, where they have access to 24-hour medical care and monitoring. This constant care and surveillance often focus on alleviating immediate health threats.

As such, inpatient treatment usually takes place in a hospital or a specialized wing of a medical facility. Some common treatments include nasogastric tube feeding and other measures to help a patient gain weight and achieve medical stabilization.²

Patients at risk of harming themselves or others, or who are struggling with co-occurring mental health conditions such as anxiety and depression, may also need inpatient treatment.³ 

What Is Residential Treatment?

Residential treatment is generally considered the second-most intensive form of eating disorder treatment. One reason it is often confused with inpatient care is that it also involves a patient staying at a treatment facility full-time. However, there are several differences between residential and inpatient treatment.

While inpatient care works to help with immediate health threats, residential treatment is more targeted toward long-term recovery. As such, stays at these facilities are usually longer, and the facilities are more comfortable and home-like rather than clinical.^4,5

Patients undergoing residential care also usually have access to a wider variety of treatments. Since these facilities focus on long-term progress, psychiatric care is usually introduced at this level of treatment, though patients will likely still undergo medical and nutritional care. Some residential treatment programs may also offer specialized care or recreational activities.⁵

Inpatient vs. Residential Treatment: Which Is Best?

When it comes to eating disorder treatment, there is no “best.” Each level of care has different advantages for people, depending on which stage of the recovery process they’re in.

When it comes to residential vs. inpatient treatment, the general consensus is that inpatient treatment should be reserved for patients who have serious mental health or physical problems,  are at risk of death or harming themselves, or who have unsuccessfully tried lower levels of care.^1,3,4

Residential treatment is recommended for people who are medically stable but still dealing with an eating disorder. Residential treatment centers provide 24-hour monitoring and support and can respond at any time in the event of a medical emergency.⁵

Other Levels of Care for Eating Disorder Treatment

Inpatient and residential rehab are not the only types of eating disorder treatment. People struggling with these conditions can—and often do—go through various levels of care, depending on their current level of physical and mental health.

Partial Hospitalization Programs

Partial hospitalization programs (PHPs) can be used to step down from residential programs and are sometimes recommended instead of residential care.⁶ These programs are also intensive, involving many hours of treatment a day, most days of the week.⁵

Patients in partial hospitalization programs receive many of the same types of care as those in residential programs, including individual and group therapy sessions, nutritional counseling, and medical check-ups. The main difference is that patients in a PHP live at home and commute to treatment.⁵

This arrangement makes PHPs more flexible than residential programs, which is beneficial for many patients. It also usually results in less costly care, though the cost of eating disorder treatment depends on a number of individual factors. As patients make progress throughout their treatment, their schedules are modified accordingly.¹

Outpatient Programs

Outpatient programs are the least intensive type of eating disorder treatment, involving regular or semi-regular meetings with a therapist or other treatment specialist and sometimes additional medical check-ins.⁷ As such, this level of care is recommended for those who are medically stable and require less intensive treatment.⁵

Those who are ready for outpatient but need more support can enroll in an intensive outpatient program (IOP). This hybrid form of treatment is a stepped-up version of outpatient care, involving 2-5 treatment sessions a week, each lasting 3-4 hours.^1,5

In any case, at the point of outpatient treatment, patients ideally need therapy as a means to check in with themselves, monitor for potential triggers, and remain recovery-focused.

Virtual Eating Disorder Treatment

In an increasingly digital world, virtual eating disorder treatment has also become a popular option for many people.

Using websites, apps, text messaging, video chats, and other forms of digital communication, virtual eating disorder treatment allows patients to access care from the comfort of their homes—or wherever they have an internet connection.

Though relatively new, one study showed that virtual outpatient treatment for eating disorders proved equally effective as an in-person partial hospitalization program.⁸ The online format makes eating disorder treatment more widely available, convenient, and cost-effective for many patients.

How to Choose Which Eating Disorder Treatment is Right for You

When dealing with a mental illness as physically, emotionally, and mentally taxing as an eating disorder, it can be difficult to determine which level of care is most appropriate for you or your loved one. That’s why the decision is best left to healthcare professionals.

When pursuing help for an eating disorder, the first step is usually securing an official diagnosis from a licensed practitioner. This professional can then help you determine the next best steps, including which level of eating disorder care may be most appropriate.

In many cases, insurance coverage will also play a part in which program or treatment level you choose. Make sure to consult your doctor and specific insurance policy for advice on navigating this situation.

Regardless of the type of care you receive, it’s important to remember that with the right help and support, you can make a full recovery from these conditions and live a happier, healthier life.

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