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.

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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. 

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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.