Eating disorders are serious conditions—not lifestyle choices—that can have long-lasting effects on physical and emotional health. Without prompt treatment, eating disorders, particularly anorexia nervosa, can be life-threatening.
Anorexia has a higher mortality rate than any other mental health issue. Current statistics suggest teens and young adults living with anorexia have a risk of death that’s 10 times higher than the risk for their same-age peers.
It’s not easy to address an eating disorder without professional support. Recovery can take a long time. It often involves setbacks and even relapse. Some people may not fully recover, but many still find treatment helps them regain some balance and deal with triggers in a positive and helpful way.
If you or a loved one is ready to get help for an eating disorder, a therapist or counselor can help you decide on the treatment that’s most likely to meet your unique needs. For many people living with severe eating disorders, inpatient care (rehab) may be the best way to start the recovery process.
When Is Eating Disorder Rehab Necessary?
The most beneficial eating disorder treatment for you will likely depend on the severity of disordered eating patterns and how entrenched they are in your life.
You might consider an outpatient program as a first approach if:
- You’re seeking early intervention before your symptoms grow worse.
- You’re unable to leave work, school, or your family.
- Your physical health is stable.
- Disordered eating behaviors or symptoms of mental distress don’t keep you from most of your usual activities.
- The cost of inpatient care is a barrier to treatment.
These programs are more flexible than inpatient programs, and they allow you to live at home. You’ll generally attend treatment multiple times a week for a few hours each day. You might work with different counselors and attend various types of counseling sessions. Some parts of treatment may include your loved ones, since family and friends are believed to have a positive impact on the recovery process.
Outpatient treatment usually doesn’t address medical issues. If you need urgent or continued care for health concerns related to an eating disorder, your doctor will likely recommend inpatient treatment or short-term hospitalization until your physical health has stabilized.
Inpatient programs offer more complete care than outpatient programs since they include meals and other nutritional support along with medical and mental health care. Your doctor or therapist may encourage you to seek inpatient treatment for an eating disorder if:
- Brief hospital stays or other short-term eating disorder treatments haven’t helped.
- Outpatient treatment or weekly therapy haven’t led to improvement.
- You’ve had an eating disorder for a long time and need both medical and nutritional support.
- Stressors in your daily life make it difficult for you to deal with triggers and focus on recovery at home.
After completing an inpatient program, you may find it helpful to continue treatment as an outpatient.
Therapy in Eating Disorder Rehab
Both outpatient and inpatient treatment programs offer a combination of individual therapy, group counseling, and skills training to help you start to address and change patterns of disordered eating. In either type of treatment, skilled counselors will offer empathy and support as you begin working to overcome an eating disorder.
Several approaches to therapy have proven beneficial for eating disorder treatment. Rehab programs typically combine several approaches since a certain treatment may not work for everyone. Types of therapy used in your program might include:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Acceptance and commitment therapy (ACT)
- Psychodynamic therapy
- Interpersonal psychotherapy
- Family-based treatment
- Art therapy
- Mindfulness-based approaches
- SMART Recovery or Alcoholics Anonymous
- Yoga therapy
The primary treatment goal is breaking patterns of disordered eating. Different approaches to therapy can help you learn to do this in a range of ways. You’ll also learn coping skills to help you accept difficult thoughts that trigger eating disorder behaviors and tools to effectively deal with challenges or painful emotions.
Eating disorder treatment also commonly works to address distorted beliefs about size and weight and their connection to self-worth. Societal messages can help reinforce eating disorder behaviors, so learning to reduce their impact can help improve treatment success.
You’ll also learn about nutrition as part of treatment. Nutrition counseling teaches you about the types and amounts of food your body needs to maintain good health. You’ll also learn more about the long-term health consequences eating disorders can have.
While rehab may prioritize stopping and changing disordered eating patterns to help you reach a healthy weight, you can also get help for substance abuse and any mental health issues not directly related to these behaviors while in rehab. Depression and anxiety, as well as many other mental health concerns, can play a part in disordered eating patterns, so it’s important to continue treatment for these issues.
Daily Life in Eating Disorder Rehab
Generally, eating disorder rehab is very structured. Structured programs can help you focus on what’s most important: your recovery.
Meals in rehab are supervised, with health care providers available to help people who need support. Mealtimes may be difficult, especially at first, and eating disorder treatment staff work to help you adjust to eating normal meals again. As part of this goal, you may eventually take planned outings to restaurants and grocery stores or spend time cooking. These activities can help you relearn healthier eating behaviors.
You’ll have therapy each day, perhaps even a few sessions. Art, yoga, and music therapies may be available, depending on your rehab center. Therapists are always available if you need support outside of scheduled therapy sessions.
Leisure time is typically supervised. Many programs don’t allow phones or computers, but you’ll have time to relax or read, draw, journal, or play board games.
Most eating disorder programs invite family members or partners to participate in mealtimes or therapy sessions several times throughout the program. Depending on your program, other visitors may be allowed when you’re feeling well enough to see them.
Possible Medical Issues
Along with therapists and psychiatrists, you’ll also work with doctors, nurses, and dietitians who can help treat any medical concerns you may have.
Medical issues can include:
- Delayed digestion and constipation
- Low heart rate
- Electrolyte imbalance, which can lead to heart failure
- Pancreatitis (inflammation of the pancreas)
- Intestinal blockages or tears
- Difficulty sleeping
- Nausea and vomiting
- Kidney failure
- Type 2 diabetes
Another serious health issue that can develop is refeeding syndrome. This happens when you begin to increase your food intake after a long period of severe food restriction. During a period of restriction, when your body doesn’t have enough carbohydrates to make energy, it will begin converting fats and proteins to energy. But as your carbohydrate intake increases, your body will begin converting carbohydrates to energy again. The sudden shift may lead to an electrolyte imbalance, which can lead to heart and kidney failure. Refeeding syndrome is fatal without treatment. If this condition develops, you’ll need to be monitored by a doctor until your organs begin functioning properly again.
Extreme malnourishment or other health concerns can make it difficult to focus on counseling. An important first step in inpatient treatment is beginning to eat normally again and restoring lost weight. It’s often necessary for your physical health to improve before therapy can help address long-standing behaviors. Regaining a healthy weight can improve your sleep, concentration, and ability to focus, preparing you to tackle emotional challenges.
Does Insurance Cover Eating Disorder Rehab?
While many insurance plans may offer at least partial coverage for inpatient eating disorder treatment, understanding the benefits your plan offers may prove challenging. Your insurance may not fully cover the treatment you need, and you may need hospitalization for a longer period than your insurance covers.
The specific treatment program you’re interested in may offer guidelines on understanding the benefits your insurance offers, talking to your insurance company, or having medical professionals write letters to emphasize the importance of prompt treatment. Some eating disorder programs may also offer assistance or information about helpful resources to people in financial need.
The National Eating Disorders Association website has a guide to insurance and legal issues you may encounter when seeking eating disorder treatment.
Entering rehab or beginning other eating disorder treatment is the first step in a journey that may be long and challenging. In treatment, you’ll work with medical and mental health professionals trained to offer support in eating disorder recovery. You’ll develop tools to cope with setbacks and learn to manage triggers in your daily life, which can help reduce the chance of relapse and improve recovery outcomes.
Depending on your needs and health, an inpatient or outpatient program may be recommended to you. The best treatment is the one that works for you. Your therapist can help you identify your treatment options. What’s truly important is getting help.
Recovery is possible, but you don’t have to do it alone. If you’re struggling with an eating disorder and feel ready to reach out, you can search our therapist directory or find a treatment center here.
- Eating disorder treatment: Know your options. (2017, July 14). Retrieved from https://www.mayoclinic.org/diseases-conditions/eating-disorders/in-depth/eating-disorder-treatment/art-20046234
- Fichter, M. M., & Quadflieg, N. (2016). Mortality in eating disorders–Results of a large prospective clinical longitudinal study. International Journal of Eating Disorders, 49(4), 391-401. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26767344
- Flesher, M. (2006). What is refeeding syndrome? Canadian Society of Intestinal Research. Retrieved from https://www.badgut.org/information-centre/a-z-digestive-topics/refeeding-syndrome
- Health consequences. (n.d.). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/health-consequences
- Insurance & legal issues. (n.d.). Retrieved from https://www.nationaleatingdisorders.org/learn/general-information/insurance
- Overview of treatment. (n.d.). UC San Diego. Retrieved from http://eatingdisorders.ucsd.edu/treatment/index.html
- Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406-414. https://www.ncbi.nlm.nih.gov/pubmed/22644309
- Statistics & research on eating disorders. (n.d.). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders
- Types of treatment. (n.d.). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/types-treatment
- What to expect from treatment. (n.d.). National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/what-expect-treatment