Many people suffer from eating disorders, which are severe mental health disorders characterized by disruptions in eating behaviors and associated thoughts and emotions. Though eating disorders are very common, there is still a stigma attached and many misconceptions about them.
One of those misconceptions is that eating disorders cannot be treated or that someone with disordered eating will suffer from it for life. Most people recover from eating disorders, and many do so through outpatient treatment.
What Is an Eating Disorder?
A few types of eating disorders are commonly found in people from all walks of life. Though some demographics are more likely to develop eating disorders, anyone can struggle with this psychological disorder.
Types of Eating Disorders
One eating disorder is anorexia nervosa, more commonly known as anorexia. This is a form of self-starvation in which the person denies themselves food, only eats a specific type of food, and/or over-exercises to lose weight.
Those with anorexia have an intense fear of gaining weight and will do almost anything to avoid weight gain. Anorexia is characterized by very low calorie intake, rapid or extreme weight loss, and a near-paralyzing fear of eating.
Bulimia nervosa is also common. Bulimia is different from anorexia because it involves purging rather than restricting.
It can sometimes be difficult to recognize at first because bulimic patients are not always severely underweight. Sometimes they are completely normal weight, and the only telltale signs are running off to the bathroom immediately after meals or over-exercising.
Believe it or not, the most common eating disorder in the country is binge eating disorder (BED). Those with BED will consume large amounts of food in short periods. These foods are typically calorie-dense. Those with BED suffer from many of the ailments common to obesity, such as heart disease, diabetes, and high blood pressure.
How Can I Recognize an Eating Disorder?
If you’re unsure if a friend, family member, or loved one has an eating disorder (or if you’re not sure about yourself and your own diagnosis), there are a few signs that might point to disordered eating.
Keep an eye out for the following, or think about whether they apply to you:
- Often eating in secret or hiding food
- Exercising to excess, or exercising to counteract food or punish oneself for eating too much
- Sudden, dramatic weight loss
- Loss of hair
- Stopped menstrual cycle
- Avoiding social events where eating will occur
- Going to the bathroom consistently right after eating, or during meals
- Having strange rituals about food, or only eating certain things
- Feeling anxiety about food, calories, etc.
- An obsession with weight gain or maintaining or losing weight
- Scarred knuckles from forced vomiting
- Refusal to eat with others/ not eating food prepared by others
How Can I Get Started Finding Treatment Options?
A good bet is always starting with your regular doctor. But whether you start with your doctor or a therapist, it’s wise to get the ball rolling by working with a team of professionals to determine the best course of treatment.
Eating disorders are tricky to treat because they involve complex psychological issues and co-occurring physical ailments.
Members of your treatment team may include any of the following trained professionals:
- Your primary care doctor: They might not be involved in your day-to-day care, but they are a person who you will want to keep in the loop about what’s going on with your treatment.
- A mental health professional: Some therapists are trained in eating disorders and body image issues and will know what you need. After all, eating disorders are, above all, psychological illnesses.
- A registered dietitian or a nutritionist: While your therapist is helping you to understand your mental illness, a dietician serves to help you understand healthy eating habits. It’s important to note that nutritionists and dieticians are not the same; whichever one you have may depend on your treatment plan.
- Medical specialists: You will likely have at least one medical doctor monitoring your physical condition. This person should be someone who specializes in disordered eating.
- Family members, friends, and loved ones: Eating disorders require a lot of care. The people you live with or are close to will be needed to help you make the huge life changes necessary to get better and recover.
Managing an eating disorder can be a long-term commitment to wellness, and it’s not something that will fix itself overnight. It may be necessary to continue to work with members of your treatment team for a long time, even if some of the more prevalent symptoms of your eating disorder are under control.
What Is Outpatient Treatment?
Outpatient Treatment, also called “outpatient” or OP, is well known for being the most effective and long-lasting form of treatment for eating disorders. Some of the most effective parts of a treatment plan, such as Cognitive Behavioral Therapy (CBT), were designed to work under real-life conditions and function best that way.
Outpatient treatment options are the most effective when recovering from an eating disorder, mostly because eating disorders aren’t like other addictions. It’s possible to quit drinking or doing drugs, but you can’t quit eating. People with eating disorders must learn how to handle food since they quite literally need it to survive.
So what exactly is outpatient treatment? It can mean several treatment combinations, and can include any of the following:
- Daily or weekly therapy sessions. Intensive Outpatient Programs (IOP) often have daily three-hour sessions, group, family, and individual therapy.
- Check in with medical specialists. The frequency depends on where you are in your treatment and how severe your co-occurring symptoms are.
- Meeting with dieticians to create balanced meal plans.
You are dealing with your eating disorder “in the real world” in the same environment in which you started to develop disordered eating patterns. Though this presents a challenge, it’s far more effective to handle the day-to-day obstacles that will come up while under the care of a treatment plan.
For many, it is helpful to stay connected to friends, family, work, and school while recovering. Unless a hospital stay is medically mandated because of a patient’s instability, dealing with everyday life triggers is a good practice to learn. Plus, some people simply cannot just take a break from their busy lives.
Another benefit of outpatient treatment is that it tends to be the most affordable option. For those who may not have the best medical insurance, this is always a welcome piece of information!
What Are the Different Types of Outpatient Treatment?
When it comes to the types of treatments that have at least some outpatient components, you are essentially looking at three different options: standard outpatient, intensive outpatient, and partial hospitalization.
Standard Outpatient (SOP)
With this type of treatment, which is the most common, the patient is medically stable and relatively able to make their own meal plans with some guidance. The person has some general knowledge of what they should eat; they just struggle to follow through on their own.
In SOP, the person sees a therapist, most likely weekly or several times a week. They are motivated to recover and ready to do the work; they just need help. Typically with SOP, the person is within relatively normal weight ranges.
Intensive Outpatient (IOP)
Intensive outpatient is just what it sounds like: a more intense version of outpatient therapy. In IOP, intensive but flexible treatment becomes realistic. It involves seeing a therapist, usually daily, for a few hours, and completing different treatments with them, as well as daily work (or every other day) with dieticians or nutritionists.
People who require IOP typically need a good deal of help to learn how to eat normally and live a normal life. While someone in IOP is likely medically stable, they may require frequent check-ins with doctors to ensure they stay that way. People are often recommended for IOP if they are not within safe weight ranges and need a lot of help to get there.
Those in severely compromised weight ranges, are not medically or psychologically stable, require constant supervision during meals, and don’t have good motivation to recover, will do well with partial hospitalization. Here, the person will stay in a medical facility, plan and prepare meals, have 24/7 medical monitoring, and attend therapy (sometimes group) while in the facility.
With partial hospitalization, the person will start in a hospital for a short period, sometimes a week or two, sometimes longer. The hope is that relatively quickly, they can be transitioned into IOP, and eventually to SOP.
Most facilities will offer various forms of aftercare to transition back into regular life. It is rare for someone to leave partial hospitalization without support in place.
How To Help Yourself
If you are struggling with an eating disorder, remember that the most important person on your treatment team is you. While support groups, therapists, and dieticians are all in your corner, you need intrinsic motivation to recover.
You need to be actively involved in your own treatment and be honest with yourself about what you need, working to communicate that with the rest of your team. Also, never underestimate the importance of your support team: friends and family.
Though eating disorders are not easy to treat, it is comforting to know that most people recover. Outpatient treatment is by far the most effective for eating disorder recovery, and whether you choose standard outpatient, intensive outpatient, or partial hospitalization, you can get better.
It all starts with recognizing your needs and making a choice. For more information, check out the National Eating Disorders Association (NEDA) website.
Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study | MHealth
New insights on eating disorders | APA