What Are PHP and IOP Treatments for Eating Disorders?

April 05, 2024

Eating disorders are serious conditions that can affect anyone, regardless of gender, age, body size, and socioeconomic background. Eating disorders impact nearly 10% of the American population, making it a significant health concern. But did you know that 45% of those who experience eating disorders achieve full recovery? And that nearly 80% of people with eating disorders achieve partial recovery? An eating disorder may seem like a daunting health condition, riddled with feelings of shame and fear, but remember that most people can recover from an eating disorder. This article will describe eating disorder symptoms and explore options for eating disorder treatment so you or a loved one can get the help and care you need for eating disorder recovery.

What Is An Eating Disorder?

An eating disorder, as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is a condition characterized by extreme and persistent changes in eating behaviors, often accompanied by negative emotions and thoughts. Eating disorders may appear as fixations regarding relationships with food and eating, preoccupation with body weight, and distorted body image. Eating disorders have significant impacts on both physical and mental health and often co-occur with other mental health conditions, like anxiety and depression.

Signs and symptoms of eating disorders can be both behavioral and physical. Everyone who experiences an eating disorder can have varying symptoms depending on the particular disorder, the severity of the disorder, the social and physical environment, and differing personal behaviors. It’s important to know eating disorder symptoms so you can identify a health concern and find support for yourself or a loved one. 

Physical signs of an eating disorder may include:

  • Fluctuations in weight
  • Gastrointestinal issues
  • Dizziness and fainting
  • Problems with sleeping
  • Thinning hair
  • Fatigue and muscle weakness

Behavioral signs of an eating disorder may include:

  • Anxiety and depression
  • Fixation on calories or other nutritional values
  • Avoidance of eating with others
  • Restriction of particular food groups
  • Excessive exercise 
  • Patterns of binge eating and/or purging
  • Preoccupation with body weight or shape
  • Social isolation

Eating disorders are serious, common and treatable. Read on to learn more about some different treatment program options and how to find eating disorder care that is right for you and your recovery journey. 

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Eating Disorder Treatment

Eating disorder treatment varies depending on a multitude of factors, including geographic location, insurance coverage, or other comorbid diagnoses. There are various levels of care that you may pursue based on your individual experience and the recommendation of healthcare professionals. Levels of care may include:

  • Outpatient treatment: The patient lives at their own home and attends weekly sessions with their healthcare provider. 
  • Intensive outpatient program (IOP): The patient lives at home and attends programming approximately two to three times a week, for at least three hours each time, in a specialized setting such as a treatment center, hospital, or virtually. The individual remains medically stable, but requires additional support to reduce eating disorder behaviors and achieve progress in recovery.
  • Partial Hospitalization Program (PHP): This level of care typically occurs five days per week for six to eight hours per day. The patient is stable, but needs intensive and structured programming to treat eating disorder symptoms. Treatments will include therapy sessions, nutrition counseling, and supported mealtimes. The patient can return home or to a transitional living facility at the end of each day. 
  • Residential treatment: This option provides round-the-clock care and supervision for those who are medically stable but still engaging in eating disorder behaviors. Regular programming such as individual and group therapy, nutrition counseling, and psychiatric care with an on-site care team provide an intensive and individualized journey to recovery. 
  • Inpatient treatment: For those who are experiencing an eating disorder that is not responding to less intensive treatment options, inpatient treatment offers a higher level of care including 24-hour medical and psychiatric support, as well as support for co-occurring mental health conditions. 

These options may seem overwhelming but working with an eating disorder specialist will help you make the best choice for your unique situation. You may also choose to join support groups, either in person or online. Another important step will be to develop a support network of friends, family members, and peer support as you begin taking steps toward recovery. 

The rest of this article will focus on partial hospitalization programs (PHP) and intensive outpatient programs (IOP), including what each treatment entails and how to make the best decision for your path to recovery. 

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What Is PHP?

Partial hospitalization program (PHP) is a type of eating disorder treatment that allows a patient to live at home or in a transitional living facility while receiving care. It is usually for patients who are medically stable but need more structured support. This care option often requires the patient to attend programming at an eating disorder treatment facility five days per week for six to eight hours per day. During PHP, patients have access to a wide variety of therapeutic intervention and medical care tailored to the specific needs of the individual. Various therapeutic modalities are offered, such as individual therapy, group therapy, family therapy, nutritional counseling, psychiatric support, and supported mealtimes. Partial hospitalization program offers intensive care with significant structure and supervision as an individual works towards recovery.

mam sitting on couch with clasped hands

What is IOP?

Intensive outpatient program (IOP) is a type of eating disorder treatment that allows the patient to return home or to a transitional living facility after receiving structured care a few times per week. IOP generally occurs three to five days per week for shorter time periods each day. There is flexibility with this level of care which allows the patient to maintain some degree of regular daily and weekly routines, such as school or work. IOP caters to the individual needs of the patient in a similar way to PHP.  Programming may include individual therapy sessions, group sessions, and family therapy as well as nutritional counseling and medication support. Because IOP is less intensive than PHP, it allows the patient to begin to transition back into their daily life while having a structured and supportive place to return and process their challenges and successes. Intensive outpatient programming also emphasizes relapse prevention and applying coping skills to manage potential triggers in their daily lives.

PHP vs IOP: Which Is Right for You?

Both partial hospitalization programs and intensive outpatient programs are powerful treatments when coping with an eating disorder. They have similar aspects of individualized care, structured therapeutic and psychiatric support, and a goal of getting you back to your daily life in recovery. Though an individual may have less access to their regular daily life during PHP, they are receiving intensive, individualized care most days per week. Alternatively, IOP gives the patient a greater range of flexibility while also maintaining structured care. IOP allows the patient to maintain work, school, and social life outside of eating disorder treatment while also providing regular weekly care. 

So which is right for you? The answer to this question depends on several factors, ranging from geographic availability of care to insurance coverage. IOP may be more accessible, but often requires integrating recovery practices and daily life, which can be challenging to juggle. PHP can be more costly given the more intensive support, but patients will have constant and regular support. Family and work responsibilities, mental health conditions, substance use disorders, and housing or commuting circumstances will all play a role in this decision. It’s important to work with your healthcare team, as well as your support network, to help you decide which option is best for you. Also consider calling the helpline at the National Alliance for Eating Disorders to talk with a specialized eating disorder professional who can offer support and resources. Regardless of what you decide, receiving care and support can be an important step in eating disorder recovery.

Seek Help

If you or a loved one is experiencing an eating disorder, you are not alone. Recovery is possible and help is available with the National Alliance for Eating Disorders.