The first step in the treatment process is acknowledging that there is a problem, and that one may be in need of support to address body image or eating concerns. Seeking help for an eating disorder may feel overwhelming, and those struggling may not even feel completely ready to begin the recovery process. This is normal; however, it’s important to keep in mind that treatment needs to start as soon as possible. Beginning the road to recovery from an eating disorder requires professional treatment. Even with a supportive network of family and friends, it is often necessary to develop a team of qualified health care providers with expertise in treating eating disorders.
Treatment Team Composition
Treatment from an eating disorder will most likely begin with seeing a therapist who may be a social worker, mental health counselor, or psychologist. Or, it may begin after a visit with one’s primary care physician. During the initial session, one’s clinician or medical provider will conduct a formal assessment, and then depending on the severity of the eating disorder, identify additional health care professionals that may be involved as well. Treatment team members generally include:
- Therapist: Therapists will work with clients to develop a trusting and caring environment so that that they feel comfortable sharing struggles with body image and eating concerns. Although one may address some of the underlying issues that could have led to the eating disorder, there will be an emphasis on identifying faulty thinking patterns, eating disorder behaviors, and management of current symptoms. One will also learn stress management techniques, to reduce the likelihood of returning to these problematic behaviors during stressful situations.
- Nutritionist / Registered Dietician: The nutritionist will guide clients in forming a healthy relationship with food, by initially designing a meal plan to support one’s health. They can help one explore new foods, identify different ways to meet the nutrition requirements for their body, and challenge any distorted thoughts in regards to their relationship with food and/or exercise.
- Psychiatrist: The psychiatrist will address any sleeping, mood, or anxiety issues that one may be experiencing. And when necessary, they will prescribe specific medications to help alleviate these conditions.
- Primary care physician: The physician will keep an eye on all medical issues that arise as a result of the eating disorder. At a minimum, physicians will check one’s weight and basic vital signs, in addition to monitoring overall health.
- Family therapist: Depending on one’s age and living situation, family therapy may involve parents, siblings, or a significant other. In this form of therapy, the family is engaged in the recovery of the eating disorder and enlisted to support the family member who is struggling.
It is very important to find a treatment team that one feels connected to and trusts. In addition, clinical expertise in eating disorder treatment is equally important when developing a treatment team. How does one go about this task? There is an additional list of questions that can greatly assist you and your family in this process.
Levels of Care
Depending on the diagnosis and the severity of the eating disorder, one may be encouraged to enter into a specific level of care. These levels of treatment are outlined below:
- Outpatient: In this level of care, one will work with a treatment team to recover from the eating disorder while on campus or at home. The health care providers will work together to ensure medical stability, in addition to focusing on a decrease in eating disordered thoughts and behaviors.
- Intensive outpatient: This level of care is for those who need more support than seeing a treatment team on a weekly basis. Although each program is different, it is most likely that this level of care will involve a 3-5 day (or evening) schedule at a hospital or residential facility. Students in intensive outpatient programs may attend school on a full or part-time basis. Although one may still continue to work with their outpatient team, this option can provide additional support (such as meal supervision and involvement in group therapy sessions).
- Partial or day hospitalization: These programs involve spending the day in a treatment facility with structured groups, usually 2 meals, and going home at night. During these 3-5 day a week programs, one will receive more intensive support through a variety of services, including individual therapy, group therapy, nutrition counseling, art or movement therapy, and case management services to ensure that all aspects of the illness are being properly addressed.
- Residential: This is a longer-term treatment option for clients that are medically stable. Generally, working on an outpatient basis or with a lower level of care did not provide the level of support needed to manage the physical and psychological aspects of the eating disorder. Most residential facilities do not feel like a hospital; this type of facility provides a “home-like” environment where one has 24-hour support from both peers and the treatment professionals described earlier. In this setting, one is most likely not attending school. All meals are usually supervised, until one begins transitioning back home or to campus. The daily schedule will include groups, nutrition support (such as meal preparation or grocery shopping), and experiential activities, such as outings with others in treatment, to help one adjust to being in situations that had previously been challenging.
- In-patient hospitalization: This is the highest level of care for those with eating disorders who are medically compromised or unable to keep themselves safe. These hospital programs include 24-hour supervision, and primarily focus on medical stabilization. Once the immediate crisis has been managed, one will transition to a lower level of care.
For additional information on levels of care, please click here, to refer to the APA’s Level of Care Guidelines for Patients with Eating Disorders.
Michelle Schlesinger, BA