What to Expect From Treatment

Reviewed by Leah Graves, RDN, LDN, CEDS-S, FAED

Eating disorder care begins with an evaluation to provide a diagnosis and recommendations for treatment. Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric care and monitoring. Treatment is focused on managing any medical or psychiatric factors that impact the ability to fully participate in eating disorders care, addressing eating disorder symptoms, nutrition state and any psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder.¹

Most of the time spent in eating disorder care is focused on psychological treatment and nutrition counseling. Psychological treatment usually involves helping an individual to identify, change and cope with emotions, thoughts, and behaviors that are negatively impacting their ability to function. There are a variety of psychological treatments that have been shown to be effective in treating eating disorders. Nutritional counseling for eating disorders typically incorporates education about nutritional needs as well as planning and monitoring an individual’s eating-related choices to support their recovery. Generally, beginning treatment as soon as eating disorder symptoms are detected is more effective and supports a shorter treatment duration. While the recovery path can take a longer period of time, it’s important to note that there is hope for recovery as individuals with long-standing eating disorders can and do recover.¹

Treatment Process¹

Eating disorders are treated by multidisciplinary treatment teams. This team includes a variety of providers who bring differing skills to treat the many aspects of an eating disorder. Treatment providers often include:

Physician (primary care physician, pediatrician, adolescent medicine specialist, etc.)

Psychotherapist

Dietitian

Psychiatrist

Case manager at your insurance company (if needed)

Additional therapists as required (yoga therapist, art therapist, etc.)²

Primary care physicians, such as pediatricians, adolescent medicine specialists, internal medicine specialists, or family doctors, may provide referrals to local psychotherapists and dietitians who have experience in treating eating disorders. Not all areas have such clinicians available, nor are all physicians familiar with eating disorder treatment.

For individuals whose eating disorder symptoms have compromised medical or nutritional stability, the first step in care will be medical stabilization and nutritional rehabilitation. Nutrition care will be designed to assist the individual in returning to an optimal nutrition state to support their ability to focus, concentrate, and participate in care as well as benefit from psychological treatment. For all eating disorder diagnoses, nutrition care focuses on restoring consistent, balanced, sustainable eating patterns while refraining from use of eating disorder behaviors. For individuals whose eating behaviors have resulted in weight loss or weight suppression, returning to a body weight that optimizes one’s ability to function in all areas of life while honoring biological heritage for shape and size will be a focus of care.

Although each eating disorder is unique, eating disorder treatment generally addresses the following factors in roughly this order:

Correcting life-threatening medical and psychiatric symptoms

Interrupting eating disorder behaviors (binge eating, purging, food restriction, excessive exercise, etc.)

Restoring weight for those whose eating disorder behavior has resulted in weight loss or lack of progression of weight in growing children and adolescents

Establishing consistent, sustainable eating patterns with nutritional rehabilitation

Challenging unhelpful and unhealthy eating disorder and ED-related thoughts and behaviors

Developing coping strategies that support recovery

Addressing ongoing medical and mental health issues

Establishing a plan to prevent relapse

Sources

^[1]Crone, C., Anzia, D. J., Fochtmann, L. J., & Dahl, D. (2023). The American Psychiatric Association practice guideline for the treatment of patients with eating disorders, Fourth Edition. American Psychiatric Association. Available at: https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890424865 Accessed on 8/3/23.

^[2] Borden, A., & Cook-Cottone, C. (2020). Yoga and eating disorder prevention and treatment: A comprehensive review and meta-analysis. Eating disorders, 28(4), 400–437. https://doi.org/10.1080/10640266.2020.1798172

Reviewed by Leah Graves, RDN, LDN, CEDS-S, FAED

Treatment Process1

Sources

Treatment Process¹