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Treatment of Eating Disorders

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Updated March 27, 2012

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Treatment of Eating Disorders
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Although eating disorders are serious, life-threatening illnesses, they are treatable by specialized professionals. It is important to seek treatment as soon as the problem is recognized as early treatment has been shown to enhance treatment outcomes. Ideally treatment will be tailored specifically to the individual, their family and the symptoms they are experiencing.

Building an Outpatient Treatment Team

Many patients are able to be treated on an outpatient basis. Typically these people have multiple professionals working with them towards recovery. Each professional plays a unique role and together they comprise a treatment team. All professionals working with a person should communicate with each other to provide the best possible treatment.

Individual, Family and Group Therapy
Psychotherapy is a cornerstone to all treatment of eating disorders and may be provided by various mental health professionals such as counselors, psychologists, nurses, psychiatrists, social workers or family therapists.

Depending on the individual needs of the client, people with eating disorders typically engage in individual and/or family therapy. This may be done by one therapist or by two separate therapists depending on the therapist's training and treatment philosophy. Commonly used philosophies in eating disorder treatment include (but aren't limited to) Family-Based Treatment (also known as the 'Maudsley Method'), cognitive-behavioral therapy, dialectical behavior therapy, and interpersonal psychotherapy.

Group therapy or support groups may also be recommended for people struggling with eating disorders. These are typically led by a therapist and may be open, in which clients can come in and out, or closed, in which there are consistent members.

Nutrition Counseling
Dieticians typically provide nutrition counseling for clients. This may include education about what nutrients your body needs and how your body uses them, as well as meal planning and monitoring weight. Learning why your body needs certain foods can help fight the distortions about food and weight that the eating disorder causes. Nutrition counseling can be an important tool to help clients get to a point where they can begin trusting their body's hunger cues again by providing essential information.

Physician
Regular monitoring by a primary care physician is also an essential component of outpatient eating disorder treatment. Physicians not only monitor a patient's weight, but also monitor lab values, blood pressure, and other potential physical complications of eating disorders. This physician may be the patient's regular family doctor or pediatrician, or may be a physician who specializes in working with eating disorders.

Psychiatrist
Psychiatrists are medical doctors, like a family physician, but have specialized training in treating mental illnesses. Occasionally, psychiatrists provide psychotherapy. However, psychiatrists typically provide medication management for patients.

Deciding to Move a Higher Level of Care

Ideally, all eating disorders could be treated on an outpatient basis, but unfortunately this simply isn't possible. The severity of some eating disorders requires more intensive interventions. While deciding that a higher level of care is necessary is never an easy decision and may be confusing, the American Psychiatric Association provides specific guidelines regarding different levels of care. Any time a person is unable to make progress in recovery on an outpatient basis, it may be time to consider a higher level of care.

Intensive Outpatient Programs
Commonly known as IOPs, Intensive Outpatient Programs allow a person to attend school or work, yet provide more support than a strictly outpatient treatment team provides. IOPs typically meet 2 to 3 days or evenings per week and often provide meal support and group therapy. Sometimes they may also provide a family night or family education component. In addition to the IOP, patients typically maintain regular appointments with their outpatient treatment team as well.

Day Patient
Typically day patient programs (also known as day treatment or partial hospitalization) are often connected with an inpatient program. They allow a person to spend the night at home but provide the structure of an inpatient program during the day. They may be considered a 'step down' for someone who has been in an inpatient program or a 'step up' for someone who is not progressing in less intensive outpatient care.

Inpatient Programs
Inpatient programs provide patients with the medical monitoring that a hospital is able to perform. These programs typically provide all of the components you would expect in an outpatient setting, such as psychotherapy and nutrition counseling, but are also able to provide a high level of structure and meal support as well. These programs are also typically able to provide medical re-feeding if it is necessary.

Depending on the program, patients may stay until they are considered medically stable or until they have reached specified goals in recovery.

Residential Programs
Residential programs are similar to inpatient programs in that they are able to provide a high level of structure, but they typically are not able to provide as much medical monitoring as an inpatient facility. Stays also tend to be longer and the program may be able to provide unique therapies, such as supported outings to restaurants.

Source:

Costin, C. (2007). The eating disorder sourcebook (3rd Ed.). New York, NY: McGraw Hill.

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