Intro
Eating disorder treatment can be delivered in a variety of settings and approaches and is generally categorized into different levels of care. This continuum of care exists on a spectrum and is meant to slowly provide more autonomy for patients as they progress on their recovery journey. There are several different treatment options available at each level of care, which generally involve a multidisciplinary team, including therapists, dietitians, psychiatrists and more. Eating disorder treatment is very individualized and there is no “one size fits all.” Certain treatment approaches may work for some, but not for others.
The Alliance understands that this can be an overwhelming and confusing time. While it may not seem possible now, it’s important to know that life in full recovery is possible. Our team of experienced experts is uniquely trained to seek out and connect you with the necessary resources to get you there. Visit our national, interactive database to find eating disorder treatment options near you today, or continue reading to discover more about the types of eating disorder treatment and levels of care.
Inpatient/Residential vs. Outpatient Treatment
Inpatient or residential eating disorder treatment occurs within a facility where the patient receives 24-hour care. This level of care provides constant supervision and higher levels of support for the patient.
On the other hand, outpatient eating disorder treatment doesn’t require overnight supervision and the patient remains at home. The level of support for outpatient care can still vary from weekly office visits to daily or every other day for several hours. These programs allow for more autonomy, independence, and the ability to “do life” while receiving treatment.
Levels of Eating Disorder Care
Outpatient Treatment
At the outpatient level of care, the individual lives at home and attends weekly sessions with their provider(s). The treatment providers have deemed the individual as medically stable, and able to recover on an outpatient basis.
Intensive Outpatient Treatment
Intensive Outpatient Program (IOP) typically occurs in a specialized setting (i.e. treatment center, hospital, virtually, etc.) where individuals attend programming approximately two to three times a week for at least three hours each time. The individual remains medically stable, but requires additional support to reduce eating disorder behaviors and achieve progress in recovery. Individuals are able to maintain work and/or attend school while in treatment.
Partial Hospitalization
Partial Hospitalization Program (PHP) or Day Treatment typically occurs five days a week for six to eight hours each day. The individual remains medically stable but requires more intensive, structured programming to reduce eating disorder behaviors and achieve progress in recovery. All services are provided in one location (or in some instances virtually) and generally include individual therapy, nutrition counseling, group therapy, family therapy, along with one or two supportive meals. The individual attends programming for the majority of the day but returns home or to transitional living in the evening.
Residential Treatment
Residential treatment provides 24-hour care/supervision for individuals who are medically stable but still engaging in eating disorder behaviors. Intensive supervision and support are required to help the individual reduce, and ultimately stop, self-destructive eating disorder behaviors (i.e. purging, restrictive eating, bingeing, compulsive exercise, etc.). Services include multiple weekly sessions of individual therapy, nutrition counseling, group therapy, family therapy, and psychiatric care. All meals and snacks are supervised and provided in a supportive environment. Residential programs may be held in medical hospital settings or on home-like grounds or estates.
Inpatient Treatment
Inpatient treatment is most appropriate for individuals whose eating disorder is either not responding to treatment in a less intensive setting or clinical evidence strongly indicates that the individual requires a higher level of care. The individual may also be at risk of harm to self and/or others that requires treatment in a structured 24-hour medical or psychiatric inpatient unit. Services include medical management and intensive treatment of physically harmful eating disorder behaviors, medical complications, and co-occurring disorders, along with a focus on weight restoration, if needed.
Acute Medical Stabilization
Acute Medical Stabilization is the highest level of care for individuals with eating disorders. This level is critical care for individuals who are medically unstable due to the severity of their eating disorder and the resulting medical complications. It focuses on physical stabilization of the patient. Once achieved and maintained, the patient can transition to a lower level of care for further treatment.
Types of Treatment and Therapeutic Approaches
Cognitive Behavioral Therapy (CBT)
This type of eating disorder therapy focuses on the thoughts, behaviors and beliefs one has surrounding food, eating, body image, and other factors. The main goal of this therapy option is to modify preconceived notions and distorted beliefs surrounding food, eating and appearance, which contribute to the development and maintenance of eating disorders.
Family-Based Treatment (FBT)
Family-Based Treatment, or the Maudsley approach, is a type of treatment where the entire family is empowered to take an active role in their loved one’s recovery. FBT is a manualized, three-phase approach that consists of refeeding, weight restoration and interruption of compensatory behaviors, returning control of eating to the individual, and establishing autonomy.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy places a focus on changing the maladaptive behaviors commonly associated among individuals struggling with eating disorders. The main goal of DBT is to develop alternative skills to combat these behaviors. In addition, patients are encouraged to practice mindfulness techniques to improve personal relationships and manage difficult emotions.
Radically Open Dialectical Behavior Therapy (RO-DBT)
Radically Open Dialectical Behavior Therapy targets a spectrum of disorders characterized by excessive self-control, often referred to as overcontrol, such as Anorexia Nervosa. RO-DBT emphasizes three aspects of emotional well-being: openness, flexibility and social connection.
Acceptance and Commitment Therapy (ACT)
ACT offers a values-based approach to eating disorders therapy. With Acceptance and Commitment Therapy, patients are encouraged to acknowledge their inner emotions as a necessary response to external and internal situations. The goal of ACT is to help patients define their own personal beliefs and values, and set realistic goals that satisfy those values.
Interpersonal Psychotherapy (IPT)
Typically associated with the treatment of Bulimia Nervosa and Binge Eating Disorder, IPT treats eating disorders in the context of patients’ interpersonal relationships. The goal of IPT is to help patients improve relationships and communication; it works under the assumption that the ability to better handle conflict, change and loss directly correlates to better control over eating disorder behaviors.
Internal Family Systems (IFS)
Internal Family Systems (IFS) is a form of psychotherapy that focuses on a client’s internal “parts” and “Self.” In IFS, the mind is considered to be naturally made up of multiple sub-personalities or families within each individual’s mental system. These sub-personalities take on different roles, such as an inner critic or inner child, and consist of wounded parts and painful feelings like anger and shame.
What Eating Disorder Treatment Option is Best for You?
Eating disorder care and treatment is complex and oftentimes not accessible for everyone. Treatment is a necessity and should not be a luxury. Remember, what works for some may not work for others, and a highly-customized approach is necessary. If you are ready to take the next step in your eating disorder recovery journey, the National Alliance for Eating Disorders will make every effort to help you every step of the way. Our team is uniquely qualified to connect you with the type of eating disorder treatment at the level of care you require to make a full recovery. Visit our national, interactive database to find eating disorder treatment options near you today or reach out to us for more help and resources.