Eating disorder treatment: Types of therapy, options

Key Points

• Almost 30 million Americans will have an eating disorder in their lives.
• The most commonly known eating disorders are binge eating disorder, anorexia, and bulimia.
• Eating disorder treatment consists of psychotherapy, nutritional counseling by a Registered Dietitian Nutritionist, and, depending on the type of eating disorder, medical intervention.
• Ongoing support from Registered Dietitians and therapists can help with managing eating disorder recovery.

About 9% of adults in the United States will face an eating disorder during their lives—almost 30 million Americans. Eating disorders are serious mental health conditions that, if untreated, can be dangerous. In fact, they have the highest death rate of any mental illness.

However, with early diagnosis and treatment, it is possible to break free from eating disorders.

Let’s explore what eating disorder treatment looks like, the types of eating disorder treatment programs available, the health dangers of eating disorders, and resources to get help.

What does eating disorder treatment look like?

Eating disorder treatment is all about taking a comprehensive, holistic approach, tackling both the mind and body.

Treatment programs are often multi-disciplinary and include:

Psychotherapy and counseling

Talk therapy is at the heart of treating eating disorders.

Cognitive Behavioral Therapy (CBT) is often recommended as a first-line treatment to treat eating disorders because it helps change the harmful thought patterns that fuel disordered eating.

Other therapies, such as interpersonal therapy (IPT) or family-based therapy (FBT), might also be necessary, depending on the situation.

• Anorexia Nervosa (AN): While there's no one-size-fits-all treatment for adults with anorexia nervosa, many do find improvement with specialized psychological therapies. For adolescents with anorexia nervosa, the science shows that home-based eating disorder therapy is more effective.
• Bulimia Nervosa (BN): For adults with bulimia nervosa, cognitive behavioral therapy, interpersonal psychotherapy (IPT), and family-based therapy (FBT) may be used. Antidepressants SSRIs like Lexapro and Zoloft may also be prescribed when necessary.
• Binge eating disorder (BED): When it comes to binge eating disorders in adults, CBT and IPT not only work well but have also been shown to be effective in the long run.

For adolescents, family-based therapy is the go-to for anorexia nervosa and has potential benefits for bulimia nervosa too. IPT might also be a good strategy to help overweight adolescents avoid excessive weight gain and curb binge eating.

Nutritional counseling

Nutritional counseling is one of the cornerstones of eating disorder therapy. Dietitians are key players on an eating disorder treatment team and develop personalized nutrition plans based on each individual’s needs.

Their guidance helps people return to regular eating habits and learn to make better decisions related to food.

Family-based treatment (FBT)

Family-based treatment (FBT) is often the first line of treatment for adolescents with eating disorders. Here, the whole family is involved in the treatment process, helping to manage meals and support healthy eating behaviors at home. It’s all about empowering parents to guide their child’s recovery.

FBT is administered in three phases:

• Phase 1: A parent or primary caregiver is responsible for the overall calorie intake and weight management of the adolescent.
• Phase 2: The adolescent gains control over their eating habits and nutrition.
• Phase 3: This phase aims to help adolescents manage stress, build self-esteem, establish an identity beyond their eating disorder, mend family ties, and address co-existing conditions like depression, anxiety, and others.

Medical interventions

Often, eating disorders can lead to serious health issues, so medical care may be necessary.

This could involve keeping an eye on vital signs, fixing electrolyte imbalances, or treating conditions like heart issues or organ damage that stem from the eating disorder.

Also, if there is depression, anxiety, or other co-existing mental health conditions, a doctor may prescribe relevant medications to help.

Types of eating disorder treatment programs

When it comes to treating eating disorders, there are several types of programs designed to meet different needs and stages of recovery. Here’s a rundown of the main types:

Outpatient treatment in private practice

Outpatient care is a great starting point if you need basic support with mental health or eating disorders. It's ideal for those easing out of intensive care or looking for a manageable way to begin recovery. 

You can opt for either in-person or online sessions, making it super flexible.

In these programs, you get individual therapy, nutritional advice, and medical check-ins, plus options for group or family therapy. You'll work with a dedicated team of professionals, including therapists and Registered Dietitian Nutritionists, who tailor your treatment plan to your specific needs.

Plus, outpatient care includes group therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), helping you build skills and find community support. 

This comprehensive approach helps tackle immediate concerns while setting you up for long-term success.

Get eating disorder treatment that fits your life. Use Fay to find eating disorder treatment near you, covered by your insurance.

Day treatment/Intensive outpatient program (IOP)

This option is great if you need structured support but can still manage to stay at home. It usually involves attending treatment sessions for multiple hours a day, several days a week. 

You get therapy, medical care, and nutritional counseling from Registered Dietitians while continuing with your everyday activities. 

The main goal of intensive outpatient programs is to help you establish better eating habits and learn different coping skills to manage stress, anxiety, and other issues that may trigger your eating disorder or slow down recovery.

Partial hospitalization program (PHP)/Intensive day program (IDP)

Partial hospitalization, also known as day treatment program (DTP), offers more structure during eating disorder treatment but also allows the individual to have the flexibility of living life outside of the treatment center. 

It works well as a transition between outpatient programs and fully inpatient treatment. This type of treatment may include group counseling, nutrition and meal support, family-based therapy (FBT), and regular follow-up sessions with a psychiatrist.

Residential/inpatient treatment

Sometimes, a more intensive approach is necessary, especially if the eating disorder is severe or there are significant health issues. Residential treatment means staying at a facility full-time and getting round-the-clock care. This environment provides a structured and supportive setting where you can focus entirely on recovery.

Managing eating disorder recovery

Recovery is a journey, and managing it effectively involves adapting strategies over time to stay on track.

Long-term recovery from an eating disorder involves ongoing management. This might include continued therapy or support groups to maintain healthy eating habits and manage any relapses.

How to find treatment for eating disorders?

Find multi-disciplinary eating disorder treatment that is clinically proven to work, either in-person or virtual, based on your preferences. 

Get started on your eating disorder recovery with Fay.

Here are some frequently asked questions about eating disorders.

What are eating disorders?

Eating disorders are serious mental health issues that involve unhealthy eating habits and a fixation on food or body image. Common types include anorexia nervosa, bulimia nervosa, and binge eating disorder.

Early diagnosis and treatment are vital because these disorders can greatly harm physical health and overall well-being.

What are the most common types of eating disorders?

In the United States, the most common types of eating disorders include:

Binge eating disorder (BED)

About 2.8 million U.S. adults are affected by binge eating disorder, the most common eating disorder in the country, according to the National Eating Disorders Association (NEDA).

It involves repeated episodes of excessive eating to discomfort, a sense of lost control during binges, and subsequent feelings of shame or guilt, without regularly resorting to compensatory behaviors like purging.

Binge eating is associated with the risk of obesity, metabolic disease, type 2 diabetes, and other health issues from overeating.

Anorexia Nervosa (AN)

Anorexia nervosa is an eating disorder characterized by extreme food restriction and distorted body image. Anorexia While the majority of people with anorexia experience low body weight, one form of anorexia, known as atypical anorexia, does not involve being underweight.

Anorexia nervosa has one of the highest mortality rates among psychiatric disorders, and people with anorexia are 20-40% more likely to have suicidal thoughts (suicidal ideation).

Other reasons for death include complications from the disorder itself, such as heart or other organ failure.

Bulimia Nervosa (BN)

Approximately 1.0% of the U.S. population, or about 3.3 million people, will experience bulimia nervosa.

This disorder involves repeated binge eating episodes followed by compensatory purging behaviors like vomiting or the misuse of laxatives. This binge purge cycle can occur several times a day to a few times a week, depending on the severity of the eating disorder.

Like anorexia, bulimia involves an intense preoccupation with food, body weight, and shape.

What are the health risks of eating disorders?

There are many health consequences of eating disorders, including:

• Heart complications: Risk of heart failure, irregular heartbeats, and death due to electrolyte imbalance from purging or laxative misuse.
• Digestive issues: Slowed digestion, abdominal pain, nausea, vomiting, constipation, diarrhea, intestinal obstruction, and pancreatitis.
• Liver and kidney damage: Potential severe organ damage affecting overall health.
• Neurological problems: Numbness, seizures, and sleeplessness can occur.
• Reproductive issues: Missed or absent menstrual periods, lowered sex drive and hormone levels.
• Metabolic and nutritional disorders: Insulin resistance, high cholesterol, anemia, and malnutrition from starving.
• Risk of coma and death: Severe cases of eating disorders can lead to life-threatening conditions.

Why is early diagnosis and treatment important?

It's really important to diagnose eating disorders early and start treatment as soon as possible. This approach significantly improves the chances of recovery and helps avoid serious health complications.

Waiting too long to address these disorders can lead to severe physical, psychological, and social problems.

Early treatment not only tackles psychological issues effectively but also boosts social and functional outcomes. This approach helps individuals reestablish healthy eating patterns, develop a positive body image, and significantly improve their quality of life.

Where to find help for eating disorders?

• Your doctor (primary care physician)
• A psychotherapist who specializes in eating disorders
• National Eating Disorders Association (NEDA)
• Fay personalized eating disorder treatment programs with trauma-informed specialists.
• ANAD treatment directory, National Association of Anorexia Nervosa and Associated Disorders
• SAMHSA National Helpline 1-800-662-4357, Substance Abuse and Mental Health Services Administration.

How can a dietitian nutritionist help with eating disorders?

Registered Dietitian Nutritionists play a key role in managing eating disorder treatment by offering specialized nutritional support, including:

• Developing personalized meal plans to stabilize eating patterns and meet nutritional needs. Addressing deficiencies in vitamins and minerals, educating on balanced eating, and debunking diet myths.
• Supporting weight restoration and helping individuals achieve a healthy weight.
• Working to improve the relationship with food through behavioral change strategies and collaborating with a multidisciplinary team to provide comprehensive care.

A Registered Dietitian plays a significant role in eating disorder recovery and rebuilding a healthy relationship with food.

If you or a loved one is battling an eating disorder, consider taking the first step. Fay can help you receive eating disorder treatment that fits your life, covered by your insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.