Everything You Need to Know About Eating Disorder Treatment

If you struggle with an eating disorder, help is available. Read on to learn about different treatment options.

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Eating disorders may be more common than you think, affecting around 28.8 million Americans, or 9% of the US population. These mental health conditions can become very serious and even life-threatening. In fact, there is one death every 52 minutes that’s a direct result of an eating disorder.

If you struggle with an eating disorder, it’s important to take action as soon as possible. Eating disorders are multifaceted, and they often co-occur alongside other mental health conditions. The psychological impacts of eating disorders are intense, but recovery is absolutely possible with a personalized treatment plan and a comprehensive care team. Here’s what you need to know about the different types of treatments for eating disorders.

Who is on an eating disorder treatment care team?

Eating disorder treatment often requires multiple providers since the impacts of these mental health conditions are both mental and physical. For eating disorder treatment, your care team might include:

1. Mental health professionals

Therapy is a key aspect of eating disorder treatment. Mental health therapists can teach you valuable coping skills and healthier ways of thinking, empowering you to heal. In some cases, psychiatrists (mental health providers who can prescribe medication) may also be a part of your care team if medication is a fit for you.

2. Medical professionals

It’s important to consult with a doctor during treatment to get your physical health in good standing. “Working with a medical team can be vitally important when treating eating disorders,” says Ashley Johnson, LCSW, Regional Clinical Director at Charlie Health. “Eating disorder behaviors can have a strong impact on a person’s overall physical health and well-being. Medical teams will want to monitor height and weight, vital signs, and blood work from labs.”

3. Nutritional counseling

Working with a dietitian or nutritionist experienced in working with people with eating disorders is key. “Nutritional counseling can help support the mental health treatment a person is providing by working with the individual to create meal plans to ensure that a person is getting the nutritional values they need for overall health,” Johnson says. 

4. Personal support system

Your family and loved ones also play an important part in your recovery. Of course, they can’t provide professional treatment, but their support is crucial, especially for kids and teens.

What are the different kinds of eating disorder treatment?

Depending on the severity of your eating disorder, different levels of care may be appropriate. Types of care settings for eating disorder treatment are:

1. Outpatient

This is the lowest level of care. Outpatient therapy is typically once a week. 

2. Intensive outpatient program (IOP)

This is a more intensive treatment option, with therapy sessions (typically a combination of individual and group sessions) occurring for multiple hours, multiple days a week. IOPs are a good fit for those who need more than once weekly therapy but don’t need extensive monitoring.

3. Partial hospitalization program (PHP)

PHPs are a step up from IOPs and are a good option for those who are medically or behaviorally unstable but do not need 24/7 care. PHPs. PHPs are sometimes called hospital day programs. They can receive medical and mental health treatment during the day but still sleep at home. 

4. Inpatient hospital stay

If your life is in danger due to mental health and/or physical health concerns, an inpatient treatment hospital stay may be necessary. Here, a medical team will get you stabilized and keep you safe 24/7 before discharging you. 

5. Residential care

Residential care is when you stay at an eating disorder treatment center for 24/7 monitoring and care. The stay may be longer term, and the exact duration of care will depend on your personal situation. 

How is therapy used in eating disorder treatment?

Therapy is often the bulk of treatment for eating disorders, including:

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• Avoidant restrictive food intake disorder (ARFID)
• Pica
• Rumination disorder
• Other specified feeding and eating disorders

A mix of therapy modalities may be used for treatment alongside additional help from other professionals. Treatment will also vary depending on the specific eating disorder you have and its severity. “In general, working from a systemic lens, involving the support system and loved ones, managing medications and medical aspects of the disorder, and looking at how thoughts and behaviors reinforce the eating disorder on a daily basis are effective across the board,” Anastasia Theisen, LMFT, Senior Clinical Supervisor at Charlie Health.

The most commonly used evidence-based therapy modalities to aid in eating disorder recovery are as follows. 

1. Cognitive behavioral therapy (CBT)

“Cognitive behavioral therapy is commonly used to help identify thoughts, feelings, and behaviors that are connected to eating disorder diagnosis,” says Johnson. “It works to identify distorted thoughts and cognitive distortions that can drive eating disordered behaviors.” 

Cognitive distortions are unhelpful, maladaptive thought patterns. In the case of eating disorders, these are typically related to food and body image. By addressing these thought patterns, you can build your self-esteem and develop a healthier relationship with food. 

A specific form of CBT called enhanced cognitive behavioral therapy (or CBT-e) is especially helpful for eating disorders. CBT is particularly beneficial for bulimia and binge eating disorder, Johnson says.

2. Dialectical behavioral therapy (DBT)

DBT is a skills-based therapy that’s an offshoot of CBT. The major pillars of DBT are mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. By learning emotional regulation and distress tolerance skills specifically, Johnson says you can learn healthy alternatives for dealing with distress rather than engaging in disordered eating.

Additionally, you and your therapist will target specific behaviors by getting a better understanding of what is driving this behavior and any other factors that reinforce the behavior. “By better understanding these, the therapist and client can create an individualized plan addressing these to help decrease the eating disorder behaviors,” Johnson says.  

3. Family therapy

Family therapy plays a large role in treatment, especially for kids and teens with eating disorders. “It can help families gain skills to help their children with these behaviors and support recovery,” Johnson says. Family-based treatment will help parents and family members understand how they can best support their loved one struggling with an eating disorder.

4. Group therapy for eating disorders

Group therapy is an excellent add-on to eating disorder treatment since it can help you feel less alone and help you learn additional coping skills. “There is a saying often used in eating disorder treatment, which is, ‘secrets keep you sick,’” says Theisen. “The eating disorder thrives on secrecy and isolation. Group therapy helps to pull clients out of this cycle and be more open and aware of how their disorder is impacting their daily life and those around them.”

Although peer support groups are available for eating disorders, Theisen recommends sticking with groups moderated by licensed professionals since challenges can arise in group settings.

Group therapy and support groups are also great options to keep your progress going after you finish a more intensive therapy program. “Support groups after treatment can also help a person sustain the progress they’ve made, especially when stepping down to a less intensive treatment –– such as if they were previously in an inpatient, intensive outpatient, or partial hospitalization program where they were getting a lot of therapeutic intervention support in a week,” says Johnson. 

How is medication management used for eating disorders?

In some cases, psychiatric medication can help those who struggle with eating disorders. Your therapist or primary care doctor might refer you to a psychiatrist for an evaluation. “Psychiatric providers are an important component in a care team for those getting treatment for eating disorders,” Johnson says. “They have in-depth knowledge of how disordered eating behaviors can impact a person’s brain functioning.” 

There are two purposes of psychiatric medications for eating disorders:

• To help get eating disorder symptoms under control
• To treat co-occurring mental health disorders

Currently, there are two medications that are FDA-approved for eating disorder treatment –– fluoxetine (Prozac) for bulimia and lisdexamfetamine (Vyvanse) for binge eating disorder.

It’s very common for people with eating disorders to have at least one other mental health condition. Research shows EDs commonly occur alongside:

• Anxiety disorders
• Depression
• Obsessive-compulsive disorder (OCD)
• Bipolar disorder
• Substance use disorder 
• Post-traumatic stress disorder (PTSD)

If you have another condition occurring alongside an eating disorder, it can make it even harder to address ED symptoms. By using medication to treat co-occurring conditions, you can improve your overall mental health. “Psychiatric providers can help treat symptoms [of these disorders] through medication management, which then can support recovery with eating disorder behaviors,” Johnson says. 

What is the role of nutritional counseling in recovery?

On top of therapy, working with a dietitian or nutritionist is crucial. “Nutritional counseling is incredibly important in recovery,” says Theisen. “There are so many misconceptions about how we should nourish our bodies, and diet culture plays a huge role.” A dietitian will help you break these negative beliefs and bust myths that are holding you back from having a balanced diet, like fats and carbs demonized by diet culture, she says.

Since eating disorders cause long-lasting patterns of unhealthy eating patterns, it can be hard to break these habits without expert guidance. Nutritional counseling can help you:

• Learn how disordered eating affects your health
• Plan your meals 
• Get in the habit of eating three meals a day
• Avoid dieting and/or binging
• Create a balanced diet that works for you
• Work toward and maintain a healthier weight

“Working with a dietitian who is passionate about healing your relationship with your body and food and promotes flexibility is extremely important,” Theisen adds.

How Charlie Health can help

If you or a loved one is struggling with an eating disorder, Charlie Health is here to help. 

Our virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for individuals who are dealing with serious mental health conditions. Charlie Health offers support for people with eating disorders and other mental health conditions. Treatment includes individual therapy, group sessions, family therapy, and medication management when needed. 

We incorporate evidence-based treatments like CBT and DBT into sessions so you can learn effective strategies to cope and prevent relapse. With this kind of treatment, you can find relief from your condition. Fill out the form below or give us a call to start your recovery journey today.