Levels of Treatment

Below is a brief description of the various levels of treatment for people with an eating disorder, from least intensive to most intensive. Most people start with the least intensive treatments, unless the eating disorder has caused physical problems (e.g., loss of menses, dangerously low weight, chronic dehydration, inability to eat) or has significantly interfered with one’s ability to live their life.

Outpatient Psychotherapy:
This involves seeing a therapist who specializes in eating disorders at least once per week. In many cases, the patient will also have other professionals as part of the treatment team. These professionals might include a physician, dietician, psychiatrist, and/or group therapist. If the patient is a child or adolescent, family therapy is likely to be an important part of the treatment.

Intensive Outpatient Program (IOP):
This is treatment that occurs for several hours a day (often in the evening), several days a week. Patients engage in individual meetings with therapists and/or dietitians at least once weekly, in addition to engaging in daily group treatment.  Often at least one daily meal is eaten at the program.

Partial Hospitalization Program (PHP):
This is treatment that occurs for 8-10 hours a day, usually at least several days per week. Patients engage in group and individual treatment.  Two or 3 daily meals are eaten at the program.

Inpatient Hospitalization:
When a patient’s physical health is in danger or the eating disorder is significantly interfering with their life, the patient may go to an inpatient psychiatric unit (often specializing in eating disorders) of a hospital for a week or more. This setting allows physicians to treat and closely monitor the patient’s physical status and try different medications as necessary. The patient is put on a meal plan and is not allowed to engage in eating-disordered behaviors. The patient typically engages in several therapy groups per day.

Residential:
When the eating disorder is significantly interfering with the patient’s life and outpatient therapy has not sufficiently helped, many patients turn to residential treatment. Residential facilities are typically solely focused on helping people with eating disorders or similar issues. Patients tend to live in these facilities for weeks or months and engage in weekly individual therapy as well as daily group therapies. There are often adjunctive therapies such as movement therapy and equine therapy. The patient is put on a meal plan and is generally not allowed to engage in eating-disordered behaviors (e.g., restricting, purging, overexercising). They work with a nutritionist in addition to their therapists, and often cook meals and go to restaurants as part of the treatment.