Eating Disorder Treatment Options
Levels of Care, Types of Treatment, and Alternative Approaches
You deserve a personalized approach to treatment.
Eating disorder treatment can be delivered in a variety of settings with different levels of care. Based on a variety of criteria recommended in the Guidelines for Eating Disorders published by the American Psychiatric Association, your therapist will recommend a specific setting that is best for you.
Empower yourself by engaging in thorough discussions with your therapist about treatment options. Familiarize yourself with your specific eating disorder and relevant clinical guidelines. Proactively communicate with your insurance company regarding your policy’s coverage. While obtaining treatment authorization can be daunting, remember that support networks exist to help you navigate this process.
What are levels of care for eating disorder treatment?
ANAD Board VP and Education Director Dr. Pat Santucci shares that treatment should generally be conducted in the LEAST restrictive setting possible that provides safety for you. Basically, the more stable you are, emotionally and physically, the lower the level of care. Outpatient is the lowest level of care, the least restrictive, and usually the first one to be tried. The highest level of care is inpatient hospitalization.
Outpatient Care (Lowest)
Most individuals are treated on an outpatient basis. Ideally, patients are treated by a multidisciplinary team, consisting minimally of a psychotherapist, nutritionist and physician. All team members should be trained specifically in the treatment of eating disorders and work together to coordinate a treatment plan. Not all individuals will receive this multidisciplinary approach but the treating clinician should have access to all of these resources.
Typically, an individual struggling with an eating disorder will see their therapist/nutritionist one to two times a week. In addition, appointments with the physician/psychiatrist may be needed to monitor status.
Recovery from an eating disorder generally takes a long time. Duration of treatment can vary from 3 months to several years, depending on the severity of the illness and diagnosis.
Intensive Outpatient (IOP)
May meet 2-3 days a week for 3-5 hours a day. Services generally include counseling, nutritional therapy, group therapy and a structured meal. Patients are medically stable and do not need daily medical monitoring. They also are psychiatrically stable and have sufficient control in normal social, educational or vocational situations and are expected to continue to make progress toward recovery.
The program offers numerous benefits, including counseling, nutritional therapy, group therapy, and structured meals. Patients are medically and psychiatrically stable, allowing them to focus on their recovery without daily medical monitoring. With a comprehensive approach, the program supports individuals in regaining control over their eating disorder and making progress towards recovery.
Partial Hospitalization Program (PHP)
May meet 2-3 days a week for 3-5 hours a day. Services generally include counseling, nutritional therapy, group therapy and a structured meal. Patients are medically stable and do not need daily medical monitoring. They also are psychiatrically stable and have sufficient control in normal social, educational or vocational situations and are expected to continue to make progress toward recovery.
The program offers numerous benefits, including counseling, nutritional therapy, group therapy, and structured meals. Patients are medically and psychiatrically stable, allowing them to focus on their recovery without daily medical monitoring. With a comprehensive approach, the program supports individuals in regaining control over their eating disorder and making progress towards recovery.
Inpatient Hospitalization
Medical Unit
Patients who are medically unstable or severely compromised may need hospitalization on a medical unit, a med-psych unit or an eating disorder medical unit. In cases of significant weight loss and malnourishment, an inpatient setting with physicians experienced in the refeeding syndrome would be indicated.
These individuals are at risk for serious or life threatening events. Symptoms that would indicate the need for inpatient treated might be related to significant/rapid weight loss, altered vital signs, abnormal laboratory findings such as electrolyte or EKG changes or co-existing problems such as diabetes.
In situations where patients are medically unstable or severely compromised, it is crucial to seek immediate medical care. Hospitalization on a medical unit, med-psych unit, or an eating disorder medical unit may be necessary. In cases of substantial weight loss and malnourishment, an inpatient setting with physicians experienced in handling the refeeding syndrome becomes essential.
Psychiatric/Eating Disorder Unit
Eating disorder patients can be treated on a general psychiatric unit. However, it is usually recommended that the individual selects an inpatient program which has a specific eating disorder program or separate specialized unit devoted to the care of individuals with an eating disorder.
Patients who meet the criteria for inpatient admission are psychiatrically unstable, may show rapid worsening of their eating disorder symptoms and may be suicidal and unable to contract for safety. Inpatient treatment provides a structured environment where 24 hour clinical care is available.
Eating disorder programs are best suited to monitor those undergoing weight restorations and address the medical/nutritional concerns of eating disorder patients while providing assistance in helping them normalize their eating patterns. In addition to providing structure and monitoring of eating patterns, various forms of psychotherapy are provided.
The usual length of stay is less than 3-4 weeks. Once the individual is considered medically stable, they are usually transferred to a lower level of care program. This can be a partial hospitalization, intensive outpatient, outpatient program or a residential treatment center.
Residential Care (Highest)
Residential care programs provide a longer term treatment option for patients who are medically stable but have not been able to reach a significant degree of psychological stability or control of their eating disorder behaviors.
This level of care may be recommended if intensive outpatient or partial hospital programs have been ineffective. Residential treatment may also be recommended after inpatient hospitalization to provide additional time for recovery in a structure setting.
The length of stay may vary, but averages 30-90 days.
These settings are live-in facilities that provide 24 hr. care 7 days a week. There is constant medical supervision and monitoring of health conditions but the patient is expected to be medically stable and require no intensive medical intervention.
At this level of care, some psychiatric impairment is expected and structured programs are provided throughout the day that offer physical and psychological healing. Usually there are a wide variety of groups that include psychoeducation, various types of psychotherapy, coping skills, nutrition and body image. Additional adjunctive therapies such as art, dance and movement, music and equine may also be available.
The facility is usually staffed by skilled multidisciplinary team composed of psychiatrists, psychologists, nutritionist, physicians, nurses, social workers and other professionals.
Most programs offer a holistic approach, but some may have a particular approach, such as 12 step. Some programs will focus on a particular population- for instance, children, adult women and adolescent girls over the age of 12, athletes, Christian-based population or individuals with co-occurring addiction or mood/psychiatric disorders
Understanding the Types of Eating Disorder Treatment
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy aims to help individuals improve their mental health by changing their thoughts, beliefs, and behaviors. Techniques may include cognitive reframing, guided discovery, exposure therapy, stress reduction techniques, and journaling of thoughts and behaviors.
Family-Based Therapy (FBT)
Often a first-line outpatient treatment for young people with eating disorders, Family-Based Therapy (FBT) empowers parents and guardians to play a central role in their child’s recovery. This structured, three-phase approach systematically addresses refeeding, weight restoration, interruption of disordered behaviors, and the gradual return of eating control and autonomy to the individual.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) helps individuals with eating disorders develop crucial alternative skills to replace maladaptive behaviors. A core component is the practice of mindfulness, which enhances personal relationships and improves emotional regulation.
To learn more about DBT activities to practice at home, we recommend checking out our Recovery Skill-building Series with Equip.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) offers a values-based framework for eating disorder recovery. Patients learn to accept their internal emotions as natural reactions to both internal and external triggers. The core of ACT is to empower patients to define their own values and beliefs, subsequently setting and pursuing realistic goals that honor these personal principles.
Interpersonal Psychotherapy (IPT)
Often a treatment for Bulimia Nervosa and Binge Eating Disorder, Interpersonal Psychotherapy (IPT) centers on how a patient’s relationships influence their eating disorder. By improving interpersonal skills—especially in managing conflict, change, and loss—IPT seeks to empower individuals to gain better control over their eating disorder behaviors.
Compassion-Focused Therapy (CFT)
Developed by Dr. Paul Gilbert, an English psychologist, CFT is an evidence-based therapeutic approach built on the belief that compassion (toward self and others) effectively alleviates the shame and self-criticism that feed psychological dysfunction. It promotes mental and emotional healing by helping clients replace internalized shame and self-criticism with acceptance and self-compassion.
Alsana, where they specialize in CFT, note that it also aids in the cultivation of mood management and relational skills and is proven effective not only in the treatment of eating disorders but in treating common co-morbidities.
Looking for a provider?
ANAD’s free, online treatment directory connects people struggling with eating disorders with professional treatment options in their area.
Exploring Other Healing and Support Practices
Explore additional supports to complement your recovery process. From yoga and art to music and mindfulness, discover proven methods that promote growth, balance, and well-being in your daily life.
Disclaimer: The practices listed below will not replace professional treatment, but may assist emotional and physical well-being, reduce stress, and promote relaxation, all of which are essential for those on a healing journey!