Different Types of Treatment Approaches for Eating Disorders

Eating disorders are mental health conditions that affect your eating habits, body image, and behavior. They’re not a “phase” or a “lifestyle choice.” They’re medical illnesses with specific symptoms and treatments.

Eating disorders affect millions of people worldwide. They’re especially common in young women, but they can affect people of all ages, genders, and races. 

There are many different types of eating disorders. The most common are: 

• Anorexia nervosa (AN): People with AN usually have a very low body weight. They also have a fear of gaining weight, and a distorted body image. As part of their illness, some people with AN also binge eat, purge using vomiting or laxatives, or exercise obsessively. You can also have anorexia and not be underweight (called atypical anorexia). 

• Bulimia nervosa (BN): People with BN have repeated episodes of binge eating and purging. These episodes usually happen at least once a week. People with BN can have bodies of all shapes and sizes. If they have a very low body weight, they’re usually more likely to be misdiagnosed with anorexia nervosa.

• Binge eating disorder (BED): BED causes binge eating episodes, at least once a week. These episodes cause feelings of shame, distress, or depression. During the binge, the person feels powerless to control what they’re eating.

Read on for more information about how eating disorders are treated, and what to expect with recovery. We’ll also talk through the different settings for treatment — from outpatient care to inpatient hospitalization — to help you understand which might be the right fit for you. 

Understanding eating disorder treatment

Eating disorder treatment isn’t one size fits all. The best treatment for you depends on a combination of your mental, physical, and social needs. But for most people, treatment includes talk therapy, nutrition education, and medical care. 

First steps

If you’re worried about an eating disorder, the first step is to talk to your healthcare provider. They can listen to your concerns and help you understand whether you have an eating disorder — and if so, which one. 

If you’re not sure whether you need to talk to a provider, the National Eating Disorder Association also has a free (confidential) online screening tool that can help you decide. 

When you meet, your provider may ask you questions about your eating behavior, like:

• Do you often feel sick or overly full after eating?

• Do you worry that you’ve lost control of how much you eat?

• Have you recently lost more than 14 pounds in 3 months?

• Do you think you’re too fat, even when other people say you’re too thin?

• Does food dominate your life?

These questions can help your provider make a diagnosis. If you’re diagnosed with an eating disorder, your provider will work with you to put together a treatment plan. They may also refer you to an eating disorder clinic or specialist. 

How are eating disorders treated?

Eating disorder treatment is unique for each person. But overall, the goals of treatment are to:

• Restore your physical and mental health.

• Change your eating disorder behaviors (like food restriction, binging, and purging).

• Establish healthy eating habits.

• Challenge negative thinking patterns.

• Help you create a plan for managing relapses.

To achieve these goals, your treatment plan might include: 

• Therapy. Talk therapy can help you understand and control your thoughts, feelings, and behaviors. There are different types of therapy, including individual, group, and family. 

• Nutrition education. Working with a nutritionist or dietician can help you understand your relationship with food. They can also help you create an eating plan that nurtures your physical and emotional health.  

• General medical care. Your primary care provider, or another doctor, can help to keep an eye on your physical health. This is a key part of eating disorder treatment, as eating disorders can lead to other mental and physical health problems.

• Medications. Different prescription medications are used to treat eating disorders, like antidepressants and antipsychotics. Some of these medications can also help other health conditions, such as anxiety, depression, and ADHD. 

Who typically treats eating disorders?

In most cases, people with an eating disorder will have a “treatment team” of different healthcare providers. This is a group of people who contribute to your care and recovery. 

Depending on your needs, your treatment team could include a:

• Primary care provider

• Psychiatrist

• Psychologist or therapist

• Nurse or nurse practitioner

• Nutritionist or dietician

• Social worker

• Case manager

• Peer support mentor

Your treatment team might be at one location (like a clinic or treatment center), or you may visit them in different locations. 

What’s the difference between outpatient, inpatient, and residential treatment?

Eating disorders are treated in many different settings. Most eating disorders can be managed as an outpatient. Outpatient treatment means you live at home, and visit your provider’s office as needed.  

But in some cases, a higher level of care is necessary. This could mean going to activities and doctor visits multiple times a week, or even staying overnight for a while in a treatment facility. 

Here are the five types of treatment settings, from the lowest to highest level of support.

Level one: outpatient treatment 

In outpatient treatment, you meet your treatment team at an office or clinic. You sleep and eat at home, and you’re able to do all of your usual activities (like go to school, work, or social events).  

Outpatient care is a good option if you’re:

• Comfortable managing your own care 

• Medically stable

Level two: intensive outpatient program 

In an intensive outpatient program (IOP), you go to a clinic or treatment center 2 to 3 days a week for several hours. You sleep and eat at home, and you’re able to continue some (or all) of your usual activities. 

An IOP may be a good option if you’re:

• Comfortable managing your own care  

• Medically stable

• In need of more frequent contact with your treatment team 

Level three: partial hospitalization program

In a partial hospitalization program (PHP), you go to a treatment center 5 to 7 days a week — sometimes for the whole day. At the center, you meet with healthcare providers and go to individual and group therapy. Even though it’s called a “hospitalization” program, you don’t actually stay overnight in a hospital. You sleep at home, but eat most meals at the center. Since a PHP is “full time,” it can be harder (or even impossible) to attend school or work while in treatment. 

A PHP may be a good option if you:

• Need help managing your care

• Are medically stable

• Need daily (or near-daily) contact with your treatment team

• Need in-person support to gain weight, or maintain a healthy weight 

• Need in-person support controlling your eating disorder behaviors

• Are dealing with another mental health condition, like depression or anxiety

Level four: residential treatment

In residential treatment, you live at a treatment center 24 hours a day. You meet frequently with your healthcare team, and go to different types of therapy. You also eat all meals at the center.

Depending on the treatment center’s policies, you may or may not be able to engage in outside activities. 

Residential treatment may be an option if you:

• Aren’t sure you’re ready for recovery

• Are medically stable

• Have a very low body weight, and cannot gain weight by yourself

• Need supervision during mealtimes

• Need hands-on help controlling your eating disorder behaviors

• Are having trouble functioning at home, work, or school

• Are having a lot of family conflict or problems

Level five: inpatient hospitalization

This is 24-hour care in a medical hospital. Inpatient hospitalization is for people with eating disorders who have a medical complication, or those who need around-the-clock supervision. 

You may need to be hospitalized if you:

• Are unable to function at home, work, or school

• Faint or lose consciousness

• Have an electrolyte (mineral) imbalance

• Have an abnormal heart rhythm

• Have a very slow heart rate

• Have a very low body temperature

• Are rapidly losing weight

• Are having suicidal thoughts

• Are addicted to drugs or alcohol

What level of care is right for me?

Choosing a treatment setting usually depends on your stage of illness or recovery, and your medical problems. Your healthcare provider can help you figure out what level of care is right for you. 

Keep in mind that people often move between levels of care. For example, you might start off in an intensive outpatient program, then switch to outpatient care as you get better. 

What eating disorder treatment works the best?

Eating disorders are complex. Symptoms differ from person to person. This means that the best treatment for you may be different from other people. 

In general, eating disorder treatment should always include a primary care provider, a nutrition specialist, and a therapist. 

What are the best eating disorder treatments for children and teenagers?

According to the American Academy of Child & Adolescent Psychiatry, the best treatment for young people is to have a team of providers who work together. 

There’s limited evidence on which exact treatments are the best. Here’s what we do know:

• Family-based treatment for anorexia. According to the American Academy of Pediatrics, family-based treatment (FBT, also called Maudsley Family Therapy) is the best treatment for children and teens with anorexia. It’s a three-phase program that involves the whole family, and it can be done as an outpatient. FBT works well, is cost effective, and decreases the need for hospitalization.

• Talk therapy for teens with anorexia and bulimia. There’s evidence that adolescent-focused therapy (AFT) and enhanced cognitive behavior therapy (CBT-E) are helpful for teenagers with anorexia or bulimia.

• Talk therapy for binge eating disorder. Therapy for binge eating disorder hasn’t been studied much yet, but there’s some evidence that interpersonal psychotherapy (IPT) can help.

• Medications. Experts agree that medication for eating disorders should only be used for children and teens if other treatments haven’t worked. Medications can be used to treat other mental health problems, like depression and anxiety. 

Best eating disorder treatments for adults

According to the American Psychiatric Association, the best treatment for adults is a combination of talk therapy, medical care, and nutritional counseling. 

We’re still learning about which exact treatments work the best. Here’s what we know so far:

• Talk therapy for anorexia and bulimia. There’s evidence that cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), and psychodynamic psychotherapy are all helpful for treating anorexia and bulimia.

• Talk therapy for binge eating disorder. There’s evidence that binge eating disorder can be treated with different types of talk therapy. This includes CBT, IPT, and dialectical behavioral therapy (DBT). 

• Medications for eating disorders. There are FDA-approved medications for binge eating disorder (Vyvanse) and bulimia (Prozac). At this point, there are no FDA-approved medications for anorexia, but they’re still sometimes prescribed. 

What if treatment isn’t working for me?

In general, most people with eating disorders can be treated as an outpatient. But if your symptoms aren’t improving, it’s possible that you may need a higher level of care. In some cases, your treatment team might also suggest adding other medications or therapies that could help.  

What if I have another mental health condition?

Many people with an eating disorder also have another mental health condition, like depression or anxiety. Fortunately, many of the treatments for eating disorders can help with other mental health conditions. 

For example, talk therapy for eating disorders can also treat other mental health conditions. And the medication used to treat bulimia — Prozac — is also FDA-approved for panic attacks, depression, and obsessive compulsive disorder (OCD). 

How long does it take to recover from an eating disorder?

There’s no set time frame for eating disorder treatment. Recovery is an individual journey. In many cases, it can take months or even years to recover. And for many people, recovery will also include occasional relapses. 

Will I have a relapse?

A relapse is when some (or all) of your eating disorder symptoms return after recovery. Relapses are common with eating disorders. There’s evidence that 20% of people with bulimia and up to half of people with anorexia may have a relapse at some point. 

Your risk of relapse is especially high in the first year after getting treatment. But it can also increase as time goes by. 

You may be more likely to have a relapse if you:

• Have had an eating disorder for a long time 

• Were first diagnosed with an eating disorder as an adult

• Have been treated in a specialized eating disorder clinic

• Continue to exercise a lot after recovery

• Continue to feel very concerned about your body weight and shape after recovery

• Have challenges with self-esteem

• Have challenges with personal relationships

For many people, relapses can also be triggered by stressful life events like:

• Career or school changes

• Pregnancy and childbirth

• Relationship changes

• Death or illness

• Menopause

Managing and recovering from relapses

During treatment, you will learn to prevent and manage relapses. This includes: 

• Learning how to identify triggers

• Learning to be aware of relapse “warning signs” 

• Having an action plan for managing a relapse

• Learning to accept relapses as a normal part of recovery

If you have a relapse, don’t be afraid to reach out to your support network and treatment team. Remember: relapses are normal, expected, and manageable. 

Why trust our experts?

Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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