Eating Disorders Clinical Treatment: What Should You Expect?
The rates of treatment success for eating disorder recovery vary, according to research. Some literature suggests that 42% of patients obtain full remission and 72% at least partial remission with treatment. Note, however, that it’s nearly impossible for individuals to recover from an eating disorder without clinical treatment. With support from medical professionals and mental health professionals, the likelihood of recovering from an eating disorder is much higher. Here, we’ll examine what clinical treatment for eating disorders typically looks like.
An overview of eating disorders: anorexia, bulimia, and binge eating disorder
The three most common types of eating disorders are binge eating disorder, anorexia nervosa, and bulimia nervosa. Each condition is accompanied by a unique set of symptoms as outlined below.
Anorexia nervosa
Anorexia involves an individual trying to keep their weight as low as possible by restricting their food intake, exercising excessively, or taking laxatives. Anorexia has the highest fatality rate of any mental illness, with an estimated 4% of patients dying from complications of their condition. However, only one in three people experiencing anorexia receive treatment, so increasing its availability would likely improve recovery rates.
Bulimia nervosa
Bulimia is an eating disorder in which an individual binge eats and then purges the food from their body to try and avoid gaining any weight. Purging may involve taking laxatives or diuretics, self-induced vomiting, fasting, or excessive exercising. Only 6% of patients with bulimia receive treatment for the condition.
Binge eating disorder
Binge eating is the most prevalent eating disorder, accounting for almost half of all eating disorder diagnoses. People with binge eating disorder regularly eat past the point of being full to an extent where they feel uncomfortable and experience guilt and embarrassment about how much they have eaten. Of the three most common eating disorders, binge eating disorder has the highest treatment rates, with almost 43% of patients obtaining treatment.
Types of eating disorders clinical treatment
The type and location of clinical treatment for an eating disorder typically depend on the severity of symptoms. People with eating disorders may also opt for a clinic or hospital setting if their home environment makes it difficult to follow their treatment plan, or if they need medical supervision in order to stabilize their health. The National Eating Disorders Association identifies four models of clinical treatment as outlined below.
Inpatient specialty eating disorder programs
If the eating disorder has caused serious physical health complications, patients may need to first be hospitalized in order to address these as soon as possible. Inpatient treatment involves 24-hour monitoring.
Residential specialty eating disorder programs
Patients who are experiencing severe eating disorder symptoms but who do not require hospitalization might participate in residential treatment. During this type of treatment, patients live at the facility and follow a schedule that includes different types of therapy, nutrition education, and time for eating nutritious meals and snacks. Residential treatment may also involve refeeding, during which patients are given certain foods to bring their weight and BMI up to a healthy level.
Partial hospital specialty eating disorder programs
If a treatment team has concerns about a patient’s physical health status but not enough to require round-the-clock care and monitoring, individuals might participate in hospital day treatment. In this setting, patients live at home and can continue with most of their regular activities but will visit the hospital once or twice a week for therapy and physical health monitoring.
Intensive outpatient specialty eating disorder programs
When a treatment team doesn’t see the need for extensive physical or mental health treatment, patients may participate in home-based outpatient treatment. Similar to hospital day treatment, they are able to remain at home but attend regular therapy to maintain the progress that they have made. If there are no immediate concerns with physical health, home-based outpatient treatment may be a likely option.
How are mental health conditions like eating disorders treated?
If you’re experiencing signs of an eating disorder, it’s typically crucial for long-term outcomes that you seek professional treatment. Treating eating disorders usually involves a multifaceted approach. The reason is that it’s crucial to address both the physical and mental health complications that often accompany the condition. So how are eating disorders treated? Some key components of treatment are outlined below.
Psychotherapy
Medical care
The Academy of Eating Disorders asserts that “adequate medical monitoring is a cornerstone of effective outpatient treatment.” Patients with anorexia in particular may require close monitoring to ensure the disorder isn’t causing significant medical complications, typically being seen at least once a week. Patients with bulimia should typically be seen regularly too, but with less frequency. Those with binge eating disorder may also require regular oversight and treatment for the health conditions that often accompany the condition, such as diabetes or hypertension.
Nutritional counseling
A registered dietician or other professional may provide nutrition counseling and education for an individual who is recovering from an eating disorder. They may also create individualized meal plans and help patients develop healthy eating habits.
Medication
While eating disorders generally aren’t treated using medication, they often co-occur with other mental health conditions, such as depression, anxiety, or post-traumatic stress disorder (PTSD). When combined with talk therapy, medications may help reduce symptoms of these comorbid conditions and reduce their impact on disordered eating patterns.
What types of medical professionals are involved in eating disorder treatment?
The minimum care team for eating disorder treatment is generally the patient’s primary care doctor and a mental health professional. Depending on the patient’s needs, other medical professionals may also be involved throughout the entire course of treatment or for specific aspects.
Primary care doctor
A primary doctor may be the first medical professional an individual turns to when they are ready to seek treatment for their eating disorder. Doctors may also be the first to notice eating disorder behaviors and express concerns. The doctor may lead the treatment of physical complications related to the eating disorder and monitor weight gain if patients are underweight.
Mental health professional
Because an eating disorder is a mental health condition, recovery also requires the support of a mental health professional such as a therapist, psychologist, or social worker. This professional will guide the patient through therapeutic treatments to address underlying psychological causes and build healthy coping mechanisms. Examples of therapy modalities that may be used for treating an eating disorder include cognitive behavioral therapy and dialectical behavioral therapy.
Nutritionist
A nutritionist or dietician’s goal is usually not just to help individuals implement new behaviors related to food and eating but to help them take ownership of their eating and develop a better relationship with food. It’s important to ensure the nutritionist or dietitian you work with is registered and has experience working with individuals with eating disorders.
Specialists
Eating disorders may result in physical health complications that require the support of a specialist. For example, almost 90% of people with bulimia experience tooth erosion and anorexia can cause teeth to become loose and fall out, both instances necessitating treatment from a dentist. Patients may also need to work with a gastroenterologist, cardiologist, endocrinologist, or occupational therapist to address other challenges.
Therapy modalities used to treat different types of eating disorders
Different eating disorders may require different types of therapy to address. First, it’s recommended that patients with anorexia who participate in CBT-ED complete up to 40 therapy sessions, with appointments twice a week for the first two to three weeks. Another treatment option is Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), which helps patients identify what keeps them attached to their anorexia and adopt healthier coping behaviors. MANTRA typically requires at least 20 sessions to be effective.
Two forms of therapy have been suggested to successfully treat bulimia. CBT is the first, which can help patients learn to modify the negative thought patterns associated with their appearance and change their eating behaviors. In addition, interpersonal psychotherapy can teach patients how to improve their relationships and more effectively address conflict.
Binge eating disorder is often treated with CBT as well. The general recommendation is 20 sessions over 20 weeks. Patients with binge eating disorder may also be offered antidepressants as part of their treatment plan in order to help manage symptoms of any contributing conditions, such as obsessive-compulsive disorder (OCD), social anxiety disorder, or depression.
Seeking therapy for an eating disorder
Again, some people with severe eating disorders and/or serious medical complications may need in-person medical treatment. In addition, therapy is usually a core component of recovering from an eating disorder.
For those who are unable to attend regular in-person therapy appointments, online therapy may be a more convenient alternative. Platforms like BetterHelp allow you to meet with a licensed therapist virtually from home or anywhere you have an internet connection. This format can allow those with eating disorders to more easily adhere to long-term mental health treatment plans.
Research suggests that online therapy can generally be as effective as in-person therapy for treating symptoms of eating disorders, particularly in conjunction with medical and nutritional support or other forms of treatment as needed.
Takeaway
What is the best therapy for eating disorders?
Family-based treatment (FBT) has been shown to be particularly effective in treating eating disorders in a family setting. In FBT, parents and family members play a role in supporting healthy eating behaviors and building coping skills. If an individual is not comfortable discussing their situation in such a setting, one-on-one methods like dialectical behavioral therapy (DBT), interpersonal therapy (IPT), and acceptance and commitment therapy (ACT) can teach coping skills to manage an intense fear of gaining weight or eating “unhealthy” foods.
Additionally, nutrition counseling offers professional guidance to help individuals rebuild positive eating habits, gain weight or lose weight (if medically necessary), and focus on balanced nutrition rather than weight loss. This type of treatment program can help to manage high blood pressure and other symptoms related to poor nutrition.
What is ARFID?
Avoidant restrictive food intake disorder (ARFID) is an eating disorder characterized by restrictive eating that goes beyond typical picky eating and can lead to poor nutrition and significant weight loss. These feeding disturbances may be due to at least one of the following:
- Low appetite and disinterest in food.
- Avoidance of foods due to sensory issues (e.g., texture).
- Avoidance of foods due to fear of consequences (e.g., choking).
If left untreated, ARFID can affect an individual’s physical and emotional health, leading to a failure to achieve a healthy weight. People living with ARFID may have difficulty with meal planning and be prone to other mental disorders.
What treatments are used for eating disorders?
Depending on an individual’s needs, a comprehensive treatment plan may include a mix of therapy, medical support, and nutritional guidance from licensed professionals and a primary care provider. Following a structured treatment plan, potentially including inpatient and outpatient programs, can promote sustainable recovery and minimize the risk of relapse.
Many patients benefit from ongoing monitoring and longer-term assistance after completing formal treatment. Proven methods like cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT) can address underlying emotional issues and related thoughts tied to body image and self-esteem. The goal is to treat eating disorders by fostering emotional health and improving overall body weight and self-esteem.
Where can someone with an eating disorder receive help?
Therapy options for individuals with eating disorders include dialectical behavioral therapy (DBT), acceptance and commitment therapy (ACT), interpersonal therapy (IPT), and family member-based treatment (FBT) therapy. In combination with these types of talk therapy, adolescent psychiatry specialists can offer tailored support for teens with eating disorders. Additionally, nutrition counseling can help an individual tend to medical complications like gastrointestinal issues that may arise as a result of an eating disorder.
Here is a nonexhaustive list of organizations aimed at assisting people with eating disorders:
- National Eating Disorders Association (NEDA)
- Project HEAL
- National Association of Anorexia Nervosa and Associated Disorders (ANAD)
- Eating Disorders Anonymous (EDA)
- Families Empowered and Supporting Treatment of Eating Disorders (FEAST-ED)
The National Eating Disorders Association (NEDA) is a highly trusted source that offers educational materials and resources for those looking to find treatment. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) provides access to free support groups and offers valuable information on recovery and self-care practices. Beat, a U.K.-based organization, offers a range of online support options for affected individuals and their family members.
What is inpatient treatment for eating disorders?
Inpatient treatment, or a residential treatment program, provides intensive, round-the-clock care where patients live on-site for a period of time according to their needs. This kind of treatment helps a person with an eating disorder improve eating habits—whether that means curbing forced vomiting and purging behaviors or working to eliminate binge eating—in an environment that provides evidence-based treatment based on medical studies, clinical trials, and best practices. In some cases, inpatient treatment can help bring patients back to a normal weight. Residential treatment programs are often highly structured and monitor patients’ food eaten. They also often take stock of patients’ mental well-being in therapy to prevent the onset of other eating disorders.
What medication is used for binge eating disorder?
Medications such as antidepressants, antiepileptics, or other specific drugs approved to manage binge eating disorder can help control the urge to binge and improve self-esteem over time. These prescription medications can be used in conjunction with support groups or one-on-one therapy to address all aspects of the individual’s mental health concerns.
However, medication is not the only treatment method for binge eating disorder. Online resources like the National Eating Disorders Association (NEDA) offer free resources. Hotlines and chat support options are also available for those in need of more immediate support. If mental health clinics are accessible to you, you may consider signing up for a specialized eating disorder program that can be personalized to meet your individual needs. Community groups, online support forums, and one-on-one therapy can also be viable sources of support.
Organizations like Overeaters Anonymous (OA) and Eating Disorders Anonymous (EDA) provide support groups where individuals can share their experiences and receive encouragement from people facing similar challenges as they work toward developing healthier coping mechanisms. Some self-help organizations meet online, and others meet in person, allowing you to choose which treatment method better suits your preferences.
How long is rehab for eating disorders?
Eating disorders affect each person uniquely, and treatment duration varies based on each individual’s needs. While some people benefit from a few months of comprehensive treatment, others require lifelong resources, particularly if they are managing other co-occurring illnesses. Each patient progresses differently depending on their diagnosis, mental health needs, and whether they require continued therapy to prevent relapse.
What triggers eating disorders?
Eating disorders arise primarily in young adults due to a complex combination of genetic, psychological, environmental, and social factors. For example, because eating disorders run in families, individuals may be at an increased risk of developing a disorder depending on family members’ health history. Additionally, societal and cultural pressures related to beauty standards and body weight can encourage body dissatisfaction. Psychological factors (e.g., low self-esteem, perfectionism), major life transitions, trauma, and factors linked to gender identity and other traits can also put an individual at higher risk of developing a life-threatening eating disorder.
How do you treat eating disorders and related mental health concerns at home?
If professional support is accessible to you, identify and seek treatment options that include counseling, support groups, and nutrition guidance to help you understand eating disorders and how they might affect you personally. Collaborating with mental health professionals who specialize in eating disorder treatment can be a great way to develop a comprehensive treatment plan that includes self-care routines and regular, nutrient-dense meals.
In addition to professional health care, engaging in self-care activities like journaling, spending quality time with loved ones, or joining a self-help group focused on eating disorders can prove useful in working through troubling elements of your life.
Track your thoughts and feelings regarding food to begin to understand what triggers unhelpful thoughts and experiment with healthier coping strategies. Avoid self-isolation and excessive exercise by connecting with a self-help group or a therapist to reinforce your motivation in a supportive and judgment-free environment. To ensure your success, set small, achievable goals along your journey to celebrate your progress as you go. Finally, be patient with yourself; recovery is a process that takes time, and setbacks are a natural part of growth.
How long do eating disorders typically last?
The duration of an eating disorder can vary widely. Some individuals may face an eating disorder for a few months, while others may work to manage the condition chronically over the course of their lives. With comprehensive treatment, recovery can be achieved and maintained.
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