Mental health
Eating disorder treatment centers: Levels of care and how to choose
Eating disorders — anorexia nervosa, bulimia nervosa, binge eating disorder, and others — have the highest mortality rate of any mental illness. Treatment is effective, but navigating the levels of care and finding a quality program requires understanding what each level provides.
Levels of care
Medical stabilization/inpatient is the highest level, for patients who are medically unstable (dangerous heart rate, electrolyte imbalances, severely underweight). This occurs in a hospital setting with continuous medical monitoring. Residential treatment provides 24/7 structured care in a non-hospital setting. All meals are supervised, therapy occurs daily, and the environment removes access to eating disorder behaviors. Stays typically run 30-90 days. Partial hospitalization (PHP) provides full-day treatment (6-8 hours) with evenings at home. Meals during the day are supervised. Intensive outpatient (IOP) provides 3-4 hours of treatment 3-5 days per week. Outpatient therapy involves weekly individual and/or group therapy with a specialized eating disorder therapist, often combined with nutritional counseling and medical monitoring.
What to look for in a program
Specialized eating disorder treatment differs significantly from general mental health treatment. Quality indicators include a multidisciplinary team (psychiatrist, therapist, dietitian, medical provider), evidence-based approaches (CBT-E for bulimia and binge eating, FBT for adolescent anorexia), medical monitoring capacity, meal support and nutritional rehabilitation, body image work, and trauma-informed care.
Finding help
The National Alliance for Eating Disorders helpline (1-866-662-1235) provides referrals to specialized programs. The Alliance website (allianceforeatingdisorders.com) maintains a treatment provider database. Many eating disorder programs have admissions teams who can help determine the appropriate level of care.