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Treating Eating Disorders
Treatment for an eating disorder is effective. The most common treatment options include psychotherapy (talk therapy), nutritional counseling, medical monitoring, and sometimes medication. In most cases, a combination of these is appropriate and shown to be more effective than any treatment option alone.
Additional treatment options are available for more severe eating disorders. Following an initial assessment, your provider can help determine the most appropriate treatment for you.
While this is not a complete list of therapeutic approaches, it includes the most common and effective approaches.
Psychotherapy
Psychotherapy, or “talk therapy,” involves working with a trained professional to gain new skills, insight, and support to overcome the eating disorder and other mental health conditions. As described below, there are different types of psychotherapy available, including (1) general psychotherapy and counseling, and (2) specific evidence-based psychotherapies (EBTs) that involve learning new skills for changing thoughts, behaviors, and/or patterns of social interaction that contribute to mental health conditions. This is not a complete list of psychotherapeutic approaches but includes some of the most effective and common psychological treatments.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) focuses on the link between thoughts, feelings and behaviors related to food and body image. CBT helps individuals identify and challenge distorted thoughts and beliefs, develop healthier coping mechanisms, and change maladaptive behaviors. It also involves building self-esteem and body acceptance.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy is a type of therapy that focuses on helping people manage intense emotions and improve their relationships. Key principles of DBT include acceptance of emotions and thoughts, developing skills to change behaviors and thoughts that are causing problems, recognizing that things can be both true and false at the same time and finding balance between opposing forces, and mindfully paying attention to the present moment without judgment.
Family-Based Therapy (FBT)
Family-Based Therapy, also known as Maudsley Family-Based Therapy (FBT-M), is a specialized and highly effective form of therapy for eating disorders that focuses on restoring healthy eating patterns and weight in children, adolescents, and young adults. It involves the whole family in the treatment process, recognizing that the eating disorder is a family problem, not just an individual one. While focusing on eating, FBT also addresses underlying emotional and psychological factors that may contribute to the eating disorder.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) helps people get “unstuck” from and detach from their thoughts. It also focuses on taking positive actions and helping people make choices that align with their values. It uses strategies such as mindfulness and goal setting to help people recognize and achieve what truly matters to them in life.
Interpersonal Psychotherapy (IPT)
Interpersonal Psychotherapy (IPT) focuses on identifying, evaluating, and improving social or relationship issues that may contribute to an eating disorder. Treatment addresses one or more interpersonal domains, removing processes that enable or maintain the eating disorder, facilitating recovery.
Nutritional Counseling
Nutritional Counseling is a specialized form of therapy that focuses on restoring a healthy relationship with food and achieving optimal nutrition for individuals struggling with eating disorders. It’s not just about calories and macronutrients; it’s about addressing the emotional, psychological, and behavioral aspects of eating. A Registered Dietician (RD) works with the patient to assess habits, preferences, and medical history, provide education and build skills, create personalized meal plans and provide support and guidance to navigate mealtimes and social situations. The RD should work closely with other members of the treatment team to ensure a coordinated approach to treatment.
Nutritional Counseling plays a crucial role in eating disorder recovery by restoring physical health, addressing emotional and psychological issues, developing healthy eating habits and preventing relapse.
Medical Monitoring
Medical Monitoring is an essential component of eating disorder treatment, acting as a vital safety net and a key driver of recovery. It goes beyond simply checking weight and height; it involves a comprehensive assessment of the body’s overall health and function, ensuring individuals receive the necessary medical care to address the physical complications of their eating disorder. Medical monitoring includes detecting and addressing physical complications, monitoring nutritional status, managing pre-existing or co-occurring medical conditions, assessing treatment effectiveness, and promoting safety and stability. Components of medical monitoring include regular check-ups, laboratory tests, electrocardiograms (EKGs), bone density scans and psychological assessments.
Medication
While not a standalone solution, medication can play a significant role in eating disorder treatment, often working in conjunction with therapy and other interventions. It’s important to understand that medication is not a cure for eating disorders, but it can help manage symptoms, address underlying mental health conditions, reduce compulsive behaviors, improve appetite and weight gain, manage physical symptoms, and improve overall well-being.
Specific types of medications that can be used include antidepressants, anti-anxiety medications, antipsychotics, mood stabilizers and stimulants.
It is important to work with a psychiatrist or other qualified healthcare professional to determine the appropriate medication and dosage. All medications have potential side effects, and it’s important to discuss them with your doctor.
Residential/inpatient treatment
In some instances, the eating disorder requires treatment under 24-7 professional supervision. This is usually carried out in an inpatient or residential setting. These eating disorder treatment programs can also provide much-needed space from triggers, as well as the opportunity to improve coping skills, begin treatment of co-occurring mental health conditions (e.g., depression or anxiety), and establish a relapse prevention plan. The latter is an important part of recovery and typically serves as a guide for ongoing treatment after the person leaves the inpatient portion of their program.
Intensive outpatient (IOP) treatment
Intensive Outpatient (IOP) Treatment offers intensive services to individuals stepping down from inpatient or residential treatment or to individuals stepping up from outpatient treatment when inpatient treatment is not needed. IOP programs typically involve several therapeutic contacts per week, usually consisting of individual psychotherapy and professionally led therapy groups as well as treatment with a psychiatrist if needed.
Support Groups
Professionally led psychotherapy-based support groups can be helpful in creating connection, overcoming challenges, fostering accountability, and developing coping skills. They are often part of a more comprehensive treatment program.
Mental health resources
Mental health resources
Get help finding treatment for eating disorders and more mental health resources.
