Eating Disorder Treatment

When treating eating disorders, medical stabilization is often the first step. Once a person is stable, the path toward eating disorder recovery can begin.

While eating disorder treatment can be difficult, eating disorder recovery is possible. Treatment usually involves the expertise of a multidisciplinary team. Eating disorder treatment programs are tailored to fit a person’s needs based on their specific eating disorder and its severity.

Hospitalization Levels of Care

Eating disorder treatment centers (sometimes referred to as eating disorder hospitals) may offer several levels of care. The eating disorder levels of care range from programs where clients will live for extended periods (inpatient or residential programs) to outpatient programs.

The level of care typically matches the intensity of the disorder. The type of treatment program someone chooses may also depend on a person’s medical conditions or complications experienced because of their eating disorder.

• Inpatient eating disorder treatment is the most involved level of care. To qualify for inpatient treatment, a patient must either be medically unstable or be experiencing severe or worsening mental health symptoms. Many people seeking care for eating disorders will begin at this level of care until they are medically stable.
• Residential eating disorder treatment programs generally require that clients be medically stable. If any medical conditions or complications are present, they need to have an existing treatment plan. In residential programs, a person will generally live on-site at the rehab center for an extended period while engaging in therapy and learning to restructure their life. Relapse prevention skills are taught in residential treatment to assist with reintegration into the community. Some residential programs allow a person to exercise increasing levels of independence by having a program level system. These clients may be relatively stable but require daily care.
• Outpatient eating disorder treatment is the least intensive level of care for eating disorders. People who qualify for outpatient programs may have already completed treatment at a higher level of care or do not require medical monitoring. A person’s symptoms will need to be relatively controlled, so they can successfully work toward recovery in a less structured setting.

Eating Disorder Therapy

Psychotherapy for eating disorders consists of many different treatment approaches. Just as there is more than one level of care, there are several approaches that are effective for eating disorder treatment. Eating disorder therapy initially aims to stabilize a person medically and then works to reduce eating disorder behaviors. Once high-risk behaviors are under control or improving, eating disorder counseling can focus on changing the thoughts and beliefs that may contribute to the eating disorder.

• Acceptance and Commitment Therapy. Acceptance and commitment therapy, or ACT, focuses on changing a person’s actions. Acceptance and commitment therapy for eating disorders helps clients accept discomfort as a part of life. This kind of therapy assists patients in committing to follow through with goals that align with core values. In the context of eating disorder treatment, these goals are likely focused on healthy eating and exercise habits.
• Cognitive Behavioral Therapy. Cognitive behavioral therapy, or CBT, focuses on a person’s thoughts and how their thinking affects their feelings and behaviors. Cognitive behavioral therapy for eating disorders works to identify and change faulty belief systems. A CBT approach to eating disorder treatment works to create change in the way a person thinks about weight, their body and food. When healthier, more effective beliefs are built and maintained, eating disorder behaviors should reduce.
• Cognitive Remediation Therapy. Cognitive remediation therapy, or CRT, has only been shown to be effective for anorexia. It has not yet been studied for efficacy with other eating disorders. A CRT approach works to challenge rigid thoughts and increase a person’s ability to think more openly.
• Dialectical Behavioral Therapy. Dialectical behavioral therapy for eating disorders focuses primarily on changing behaviors. Skills are taught to support recovery from disordered eating. This approach works to increase a person’s ability to tolerate negative feelings without acting out.
• Family Therapy. Family therapy for eating disorders is most commonly used with children and adolescents. The initial focus is on weight restoration. Family members assist in fostering healthy eating and exercise habits. Control is given to the patient primarily with the remainder of the family being used as necessary supports.
• Nutrition Counseling. Nutrition counseling for eating disorders is used along with many of the other treatment approaches described. Nutrition counseling involves a nutritionist or dietician assisting a patient in weight restoration and implementing healthy eating habits. Clients are educated in nutrition and are taught to fulfill their caloric needs while eating healthily.

Medications for Eating Disorders

While there are no specific medications for eating disorders, there are several medications that can be used to assist in treatment. The most commonly used type of medications are antidepressants. Frequently a person with an eating disorder struggles with feelings of guilt and shame. These negative feelings are associated with depression. By treating underlying depressive symptoms and thoughts, a person may be more responsive to other forms of treatment.

Mood stabilizers may be used to regulate impulsive tendencies related to binging and purging. For some individuals with binge eating disorders, medications have been used with some success to suppress appetite and reduce overeating. Supplements may also be used to restore a healthy balance of nutrients in a person’s body as they recover from an eating disorder. Supplementation allows a person to experience increased feelings of wellbeing at a faster rate than would otherwise be possible. This improved sense of well-being can increase motivation levels and improve treatment success rates.

Relapse Prevention

Eating disorder relapse prevention is a primary focus of eating disorder treatment. Once a patient is stabilized, there may still be a risk of eating disorder behavior relapse. Creating a comprehensive eating disorder relapse prevention plan provides clients with a guide on how to handle difficult situations. Most relapse prevention plans include:

• Triggers
• High-risk situations
• Distraction techniques
• Replacement behaviors
• Supports to contact
• Coping strategies

Some relapse prevention plans include ideas of how to maintain recovery daily, too.

How to Help Someone With an Eating Disorder

Watching someone struggle with an eating disorder is hard. It can be even harder to approach a loved one with concerns about a potential eating disorder. Expressing concern without judgment can be helpful when starting a conversation about eating disorder behaviors.

Providing support while determining how to help someone with an eating disorder can reduce feelings of guilt and shame. These negative feelings may be part of the reason why many people do not seek treatment. Support groups and helplines are available to offer support in finding treatment.

Eating Disorder Support Groups

Eating disorder support groups, such as Eating Disorders Anonymous, can help a person to feel less alone. Normalizing the experience of struggling with an eating disorder can help reduce shame. Seeing individuals who have begun the recovery process can also instill a sense of hope in people who are just starting to seek help. Meetings including face-to-face and phone meetings can be located online.

Additional eating disorder support groups include:

• National Eating Disorders Association (NEDA)
• National Association of Anorexia Nervosa and Associated Disorders (ANAD)
• Overeaters Anonymous (OA)

Eating Disorder Hotlines

An eating disorder hotline is a toll-free service aimed to help people who have an eating disorder. Calling an eating disorder helpline can also be helpful for people who have a loved one with an eating disorder. When calling an eating disorder 24-hour hotline, expect to answer questions about the eating disorder. Some common questions may include describing the eating disorder, whether any other conditions are present, and a willingness to enroll in a program. Calling an eating disorder hotline can help connect people to treatment.

The National Eating Disorder Association (NEDA) runs a free, national hotline available Monday–Thursday, 9:00 am EST – 9:00 pm EST and Friday, 9:00 am EST– 5:00 pm EST.

• Call 1-800-931-2237
• Text “NEDA” to 741-741

Treating Eating Disorders and Co-Occurring Conditions

When seeking treatment for eating disorders, the presence of other co-occurring disorders should also be considered. Eating disorders frequently co-occur with other mental health disorders such as depression, anxiety and substance use disorders. For someone who has another mental health condition (or an addiction) along with an eating disorder, dual diagnosis treatment allows all conditions to be treated simultaneously.

If you or a loved one are struggling with an eating disorder, help doesn’t have to wait. The Recovery Village offers comprehensive dual-diagnosis treatment plans to help people overcome drug or alcohol addictions and co-occurring eating disorders. Contact a representative at The Recovery Village today to take the first step in your recovery journey.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Denise-Marie Griswold, LCAS

Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more