Eating disorders are complex mental health conditions and their treatment is no less so. This can make the idea of entering a residential or outpatient treatment center intimidating for the individual going into treatment. For that reason, it’s important to be informed about what kinds of treatment to expect – the more a potential client knows, the better they can prepare to get started on recovery.
While the center will make every effort to inform their incoming clients, it’s best to become informed about what to expect even before making your first call. It will help you ask the right questions about treatment before committing. With that in mind, anyone considering going into treatment should know that a comprehensive eating disorder treatment plan will incorporate three core types of treatment: medical, nutritional, and psychological.
Medical Treatments for Eating Disorders
If an incoming client is displaying signs of malnutrition or other physical symptoms of eating disorders such as bleeding in the throat, anemia, or gastrointestinal issues, the treatment center’s priority is to medically stabilize the client. Note that each type of eating disorder may have different physical manifestations. For example, a person with binge eating disorder might experience type 2 diabetes or heart disease related to weight gain, whereas a person with ARFID might show vitamin deficiencies or weight loss.
Many individuals diagnosed with eating disorders never require hospitalization. However, for those cases where it’s needed, the treatment facility normally provides 24/7 medical support including medical doctors, trained nurses, and psychiatric professionals. Before the other kinds of treatment can begin, medical stability is essential. At the outset of a residential stay, round-the-clock coverage might be necessary; later on, the client will join the milieu with other clients who are out of medical crises.
In outpatient programs, the treatment center normally arranges for medical treatment at a local hospital or clinic. Normally, those medical professionals will have experience with the unique needs of eating disorder patients. Afterward, there are PHP (partial hospitalization programs) and IOP (intensive outpatient programs) that can help provide coverage for the specific medical needs of the client. Otherwise, day treatment programs tend to focus on therapy and behavioral modification.
Nutritional Treatment for Eating Disorders
A common result of long-term eating disorders, including bulimia nervosa, anorexia nervosa, and binge eating disorder, is nutritional imbalance and malnutrition. These symptoms require specialized nutritional plans and education to correct. Some of the nutritional treatments available at eating disorder treatment centers include:
- Education concerning how nutrition impacts one’s body and how a lack of proper nutrition is linked to physical and mental function
- Identifying how eating disorders and their associated disordered behaviors disrupt balanced nutrition
- Teaching how to design a balanced meal plan in a sustainable fashion
- Seeking to incorporate a regular pattern of eating and how to avoid urges to purge afterward
- Providing anti-diet education, outlining clearly how diet culture interferes with a healthy relationship with food and eating, eventually leading to disordered behaviors
- Finding pathways to correct health concerns that result from malnutrition and other risks associated with eating disorders
In residential treatment, meals are planned and provided by the center and staff. However, they tend to also provide training on how to plan meals. It’s important for new graduates from a residential program to continue their nutrition plan when they return home, even if they participate in a step-down program. Without maintaining proper nutrition, it’s easy to fall into a relapse of disordered eating behaviors.
Outpatient or day treatment programs also place a premium on meal planning and nutritional programming. Since the individual is planning most of their meals and snacks by themselves (although planned meals may be part of the outpatient experience), they should receive instructions on the types and amounts of food to eat. Nutritionists and dieticians are usually central parts of an outpatient eating disorder program.
Psychological Treatments for Eating Disorders
Therapy involves seeing a psychologist, therapist, or other mental health professionals. During residential treatment, this is performed daily over the course of at least 30 days, although sometimes longer. Outpatient therapy can continue following residential’s ending, sometimes for years, but it can also be the primary option. Some of the goals and techniques of psychological treatment include:
- Developing coping skills and mindfulness techniques to counter urges to engage in disordered eating
- Identifying self-destructive feelings and ideas and adopting new habits that better serve to help the individual live a full, happy life
- Developing relationship management skills, including family therapy sessions that provide a basis for support following return to daily life
- Encouraging group meals, communal shopping and cooking, and other food-related activities with the client’s peers in treatment
- Skills building for maintaining an awareness of one’s relationship with food and one’s emotional condition on a day-to-day basis
- Stress tolerance training to help the client process and defuse stressful situations without resorting to disordered eating behaviors
Therapy has moved beyond the stereotype of a psychoanalyst talking to a client laying on the couch, moving to more evidence-based clinical techniques honed over decades. Some of the most common types of therapy are:
- Cognitive Behavioral Therapy (CBT): CBT is one of the most popular forms of evidence-based therapy used today. A major focus of CBT is on the thoughts and feelings one has and the way those thoughts and feelings can lead to unwanted or undesirable behaviors. When treating eating disorder symptoms, CBT can help individuals recognize and alter disorder or negative emotions or actions associated with the eating disorder.
- Dialectical Behavioral Therapy (DBT): A form of CBT originally designed for suicidal people and those with borderline personality disorder, DBT focuses on two central parts of behavioral therapy: acceptance and change. The client learns to accept their disordered behaviors objectively, and then accept that they need to change those behaviors. DBT can be effective in both individual and group therapy settings.
- Family-Based Therapy: The family of the individual diagnosed with an eating disorder can play a helpful role in recovery in a variety of ways. However, it can be difficult for family members to know what to do and what not to do without a little guidance. Family-based therapy provides a foundation for family members to learn how to support the individual diagnosed with an eating disorder, including helping them restore desirable eating patterns.
Getting Help for Eating Disorders Starts with Asking
If you or a loved one has been diagnosed with an eating disorder by a professional therapist or psychiatrist, they will help you locate more specialized treatment, often recommending an eating disorder treatment facility nearby. If you have suspicions but have not received a diagnosis, you should contact a therapist who specializes in eating disorders for an assessment as soon as possible. The longer an eating disorder goes on without treatment, the hard it is to correct, even with specialized treatment. Thus, it’s essential to seek out help when eating behaviors begin to negatively affect your life. Getting started may sound difficult, but with knowledge of what to expect, it’s easier than you think.