How Are Eating Disorders Treated?
Eating disorders often involve a team of clinicians to address different elements of the illness. A physician may monitor physical changes and problems, a psychologist may address underlying thoughts and emotions, and a nutritionist may develop a plan to maintain a healthy weight moving forward. Most people can be treated in an outpatient setting, but some may need a residential or inpatient facility. Seeking treatment as early as possible raises the likelihood of a successful recovery.
On This Page
- When is inpatient treatment necessary?
- What are different types of treatment for eating disorders?
- What is Enhanced Cognitive Behavioral Therapy?
- What Is Family-Based Treatment?
- Do any medications treat eating disorders?
- Will insurance cover treatment for an eating disorder?
- Someone I love has an eating disorder. How can I help?
- How do you help someone who refuses treatment?
It can be difficult to know how to help someone with an eating disorder; in addition to being painful to understand and discuss, the severity of the condition varies widely.
Individuals with an eating disorder should consult with a medical professional about whether they need inpatient or outpatient treatment. Doctors may assess body weight, vital signs, blood work, and other metrics to determine whether the person is physically and psychologically stable. If not, she or he will need to be admitted to an inpatient facility.
However, if you are concerned for someone’s immediate safety, such as if their physical health has deteriorated, seek medical attention or call 911.
Eating disorders treated in an outpatient setting employ a variety of therapies. Leading treatments include Cognitive Behavioral Therapy and Enhanced Cognitive Behavior Therapy as well as Family-Based Treatment. Clinicians may also practice therapies of other kinds, such as Dialectical Behavior Therapy, Acceptance and Commitment Therapy, or Psychodynamic Therapy.
Eating disorders are often treated with Cognitive Behavioral Therapy or Enhanced Cognitive Behavioral Therapy. CBT-E was created specifically to treat eating disorders. It encompasses a personalized treatment approach, addressing the thoughts that maintain the disorder and leading the individual to decide for themselves to maintain a healthy weight.
CBT-E also addresses important barriers to change, such as perfectionism, low self-esteem, and relationship challenges. As some researchers have described, “The eating disorder psychopathology may be likened to a house of cards with the strategy being to identify and remove the key cards that are supporting the eating disorder, thereby bringing down the entire house.”
CBT-E treats eating disorders of any type, including anorexia, bulimia, and binge-eating disorder. There are versions for older and younger patients, and for inpatient and outpatient programs. Treatment typically involves one 50-minute session per week for 20 weeks. For those severely underweight, treatment can span a longer period such as 40 weeks and incorporate weight regain in addition to addressing problematic thought processes.
Clinical trials show that CBT-E effectively treats eating disorders; however, further research is needed to determine whether it is consistently more effective than cognitive behavioral therapy.
Family-Based Treatment (FBT) is a leading treatment for adolescents with eating disorders. It’s also referred to as the Maudsley method, named for the British hospital where it was created in the 1970s.
The approach incorporates the entire family. It helps parents support their children to eat and restore a healthy weight. In this process, parents assume control over the child’s eating before gradually shifting that power back to the child.
Studies have confirmed that Family-Based Treatment is effective in helping adolescents heal. Yet parents should be aware that it requires a large commitment in terms of time and energy, and that it is more appropriate for some families than others.
Medications may be prescribed to address relevant symptoms, such as anxiety or depression. But there are currently no drugs approved to treat eating disorders.
Some medications are known to cause weight gain, but patients won’t submit to gaining weight without addressing the underlying psychological challenges prompting the disorder. This also hinders drug discovery due to participants in clinical trials.
Insurance coverage for eating disorder treatment is variable. Most insurance plans have some coverage for mental health care, but they may differ with regard to how much they reimburse for therapy or inpatient treatment. The National Association of Eating Disorders provides a list of statements that may be helpful in supporting your insurance claims.
Although the decision to seek treatment may seem extremely clear to a loved one, it can be difficult and overwhelming for the person struggling. It can help to research eating disorders to better understand the condition and empathize with their experience.
Helping someone with an eating disorder arrive at the decision to seek treatment can be a long process. It may involve asking the person about their thoughts and feelings, helping them admit that they have a problem, and reflecting on goals for their future that might make treatment feel necessary and important.
When discussing treatment, it can be valuable to share resources, such as mental health professionals in the area who take their insurance, and offer to attend an appointment with them. Encourage the person to get both psychological help and a medical exam. Later on, check in to make sure they followed through on the plan that you discussed.
People may refuse treatment for numerous reasons—they may not believe they have an illness or they find the idea of confronting the disorder extremely anxiety-inducing. Continuing to support someone and encourage them to seek treatment over time can be very helpful, as can providing resources to make the next steps feel easier.
Beyond providing love and support, parents who are urgently worried about their child can consider making certain financial resources, such as a car or college tuition, dependent upon seeking treatment. For children under 18, parents can require treatment or admit them to the hospital.
For those over the age of 18, legal actions can be taken to control medical care such as a guardianship or conservatorship. Although these drastic measures are a last resort, loved ones sometimes feel they are necessary since they are dealing with a potentially deadly disorder.