Guide to Professional Treatment Options

If you determine, whether before even beginning the journey or somewhere along the journey, that your symptoms are more severe than can be adequately quelled with this kind of a self-directed recovery, you will want to consider professional treatment.  What follows is just a quick guide for finding the appropriate level of care; it is not comprehensive by any means.

These are listed in order from the mildest to the most intense option, in terms of your recovery needs.  The criteria for each level is grounded in commonalities between most treatment facilities and clinicians, but they are not official criteria.

Looking for the most comprehensive disordered eating quiz out there? Click here to take this free assessment and see on which of the 9 levels of disordered eating you rank, along with a comprehensive readout of which next steps to take!

Want to learn more about each eating disorder? Check out these ultra comprehensive overviews!

Recovery Coaching

Technically, this is not an “official” treatment option.  A recovery coach is not necessarily a licensed professional (in fact, most coaches do not have a state-recognized license, but there are of course exceptions to this).  Rather, this individual works to help you through your recovery.  While you are responsible for most of the work required to recover, this coach will be there alongside you (whether in-person or virtually) to guide you through the process.  This serves the purpose of accountability and support.  Most recovery coaches have recovered from an eating disorder themselves.

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This is the “mildest” form of professional treatment, and what it entails is self-explanatory.  Whether you are seeing a therapist, psychiatrist, dietitian, general practitioner, or any other medical professional ideally well-versed in the treatment of eating disorders, this individual is reached for standalone sessions. 

You might see a therapist once a week and a dietitian once a week, for example.  The frequency will be decided upon your initial consultation and will likely be tweaked over time.

Start by looking up professionals who either specialize in eating disorder treatment or have a long history of working with patients with eating disorders.  When first talking with them, before setting up an appointment, make sure to ask any and all questions you have about their approach. 

For example, do they take a body-positive, anti-dieting approach? Will they be respectful of your boundaries? Don’t feel bad asking these questions; this is someone who will ostensibly be discussing and dealing with some of the most personal elements of your life, so knowing that they will be respectful and professional is of utmost importance.

Intensive Outpatient (IOP)

IOP is similar to outpatient, but it comprises more frequent visits and often a more comprehensive treatment team.  There are usually 3-5 sessions a week, each one lasting around 3 hours.  These are more organized than the isolated outpatient professionals you would otherwise have seen, and it is common for these to utilize group therapy and to have patients eat at least one meal together.

If you are medically stable and not in need of round-the-clock treatment, yet you know you need something with organized and frequent accountability, this could be the right option.

Partial Hospitalization (PHP)

At the level of PHP, you can expect to meet a minimum of 5 days per week.  Each day is a full day of treatment, but you do not stay at the center.  Essentially, PHP is “day treatment.”  During this time, there will be at least two group meals (sometimes solo meals are utilized as exposure therapy, on a case-by-case basis), and there will be a handful of various therapy activities.  Patients usually stay in PHP an average of 4-6 weeks before discharge.

The ideal candidate for PHP is medically stable yet requires medical supervision for certain ED-related symptoms (for example, POTS or orthostatic hypertension).  As well, in terms of psychiatric status, PHP is right for you primarily if you are in a stable enough state to process mainly therapeutic treatment but are not quite ready to be out on your own for extended periods.

Residential Treatment (RTC)

Take PHP and make it a 24/7, stayaway ordeal and what you’ve got is known as residential treatment.  Having experience working at this level, I can say with certainty this option is reserved for those in severe need of round-the-clock monitoring and who are likely not medically stable yet not in dire need of acute refeeding

The average length of stay is still 4-6 weeks here, after which point patients are almost always stepped down to a lower level of care.  It is rare to go from RTC to being out on your own, which speaks to the degree of intensity in this treatment.  At a residential center, you can expect to have constant access to therapists, counselors, a dietitian, nurse, and a medical doctor. 

If you believe (or the director at a lower level of care decides) you cannot be trusted to avoid engaging in behaviors on your own, RTC may be necessary.   

Inpatient (Hospitalization)

Inpatient care is reserved for those in dire need of refeeding, so patients at this level have severe comorbidities that cannot be addressed adequately in lower levels of care.  The difference between RTC and inpatient is that the former is a house where a group of 6-8 patients stays and has abundant access to treatment team professionals, whereas the latter is usually located in an ICU ward in a hospital. 

Inpatient is where more serious measures of refeeding, including nasogastric feed tubes and total parenteral nutrition, are employed.  If your body weight or other concomitant conditions linked to your eating disorder bar you from being eligible for psychotherapeutic treatment, this is where inpatient comes into play.

For more information on professional treatment options, including which questions to ask providers and how to find a qualified in-network provider, NEDA has one of the most comprehensive resources around. Click here to learn more.