Eating Disorders: Treatment Options

Treatment for an eating disorder is a very individualized process. Therefore, there are different types of treatments depending on how medically-stable a person is and how much emotional support they need. 

What to expect at each level of treatment:

Outpatient: for people who are beginning to struggle with an eating disorder, or who are stepping down from residential or intensive outpatient. There are two approaches to outpatient treatment: multi-disciplinary and family-based. 

Multi-disciplinary: This type of treatment often involves regular meetings with ALL members of the treatment team. Medical providers usually schedule weight-checks for patients who are recovering from an eating disorder anywhere from 3 times a week to once a month. They may also want to check your blood pressure, heart rate, and urine to make sure you are drinking enough fluids.

Family-based: This type of treatment puts parents and/or family members in charge of the recovery process. Family members typically control their teen's meal plan and offer support at every meal and snack with guidance from a therapist who specializes in family-based treatment. Family-based treatment is usually done at home, and may not involve other treatment providers other than a medical doctor, but can.

Intensive outpatient 

A. Partial outpatient: This type of treatment is for people either transitioning back into school, work, etc. from residential treatment, or for people who are not ready for or do not require a higher level of treatment. Intensive outpatient treatment usually involves after school group meetings 3-5 days per week. The amount of time spent at the program each day varies between programs. Usually 1 meal is provided and supervised.

B. Partial hospitalization: This type of treatment is provided during the day and 2-3 meals are provided along with group and individual therapy, and nutrition education. Patients in partial programs go home at night.

Residential: This type of treatment is for medically stable patients who need a very structured level of treatment. Patients live and sleep in a center with other young people. Patients in residential programs have frequent meetings with their team (therapist, nutritionist, nurse and/or health care provider, and psychiatrist) and have a lot of group meetings. After residential treatment, patients often meet with an outpatient team, or transfer to an intensive outpatient program.

In-patient: This type of treatment is for people with severe eating disorders who are medically unstable or people who were unsuccessful with treatment at a lower level. Patients receive 24-hour hospital supervision and care and have a very structured schedule. Once medically stable, patients may go home or to residential treatment.

Treatment of eating disorders varies from person to person. Some people only do outpatient treatment, while other teens may need to transition through some or all levels of care as part of their eating disorder treatment. Transitioning into outpatient from inpatient or residential treatment may be very challenging in the beginning.

Important things to remember when transitioning from inpatient or residential to outpatient treatment:

• Before you leave inpatient or residential treatment, set up an outpatient team that you can meet with regularly. Ask your treatment team to help you find providers that you get along with and who accepts your health insurance. Usually an outpatient team consists of a therapist, nutritionist, HCP or nurse practitioner, and often psychiatrist and a family therapist.
• Some days will be easier than others. It's OK and normal for you to have some challenging days.
• It will be your responsibility to follow your meal plan when you are in an outpatient setting, not engage in unhealthy behaviors, and maintain a healthy weight.
• Don't be afraid to seek support from family and friends when necessary, especially around meals. In some cases, your parents might be asked to be in charge of your meal plan.
• Think about one meal at a time, and try not to become discouraged if you have a hard time once in a while.
• Be completely honest with your treatment team and tell them if and when you have any thoughts about disordered eating or if you begin using unhealthy behaviors again.

Group Support Meetings can also be helpful before treatment or during recovery. People suffering from eating disorders often find it helpful to meet other people who are experiencing similar challenges. Group meetings are both encouraging and valuable because young women (and sometimes men) can share stories, feelings, accomplishments, and coping methods. Group meetings can usually be found at local health centers, agencies, or schools.

Written and reviewed by the CYWH Staff at Boston Children's Hospital
Source: youngwomenshealth.org