Levels of Treatment for Anorexia

Anorexia nervosa (AN) is a serious mental health condition that can be dangerous or even deadly if left untreated. Still, AN can present in several different ways, with eating disorder symptoms taking on varying levels of severity.

To cater to these differences, there are different levels of care to treat anorexia nervosa and a number of treatment methods that can help people improve their mental, physical, and emotional health.

Levels of care for AN and other eating disorders generally refers to the intensity of someone’s treatment program, and they can span from intensive, 24-hour monitoring and treatment to regular appointments with a therapist or even self-care from home.

If you or a loved one are struggling with anorexia nervosa, a medical professional can help you determine the best level of care for your particular case. But below are some general descriptions of what each level entails.

Inpatient Care or Hospitalization

Inpatient care is generally what would be considered the most intensive level of treatment for an eating disorder. This type of treatment involves staying at a treatment facility overnight to receive around-the-clock care and monitoring. 

Others who may qualify for inpatient hospitalization include those experiencing a mental or physical health crisis. The overall goal of inpatient hospitalization is medical stabilization; stays are usually considered temporary.

Once someone has been medically stabilized, they can move on to residential care. This form of inpatient treatment is still intensive but takes place in an environment that’s more home-like than clinical, where patients receive treatment geared toward more long-term recovery goals. Individual and group therapy sessions, meal monitoring and planning, nutritional counseling, and regular medical check-ins are often part of a residential program, with the overall treatment generally lasting at least 30 days but sometimes up to several months.⁵

Day Treatment or Partial Hospitalization Programs (PHPs)

A partial hospitalization program (PHP) is also known as day treatment, as patients attend treatment sessions during the day but return home at night.

Despite this difference, PHPs can be very similar to residential programs in intensity and daily schedules. Patients often see a medical professional or team of medical professionals up to 10 hours per day, 6 days a week.⁵

In addition to the therapy and nutritional counseling they receive, part of the care regimen may involve working to treat severe malnutrition, a result of significantly low body weight, which is common among people who have been struggling with anorexia for an extended period. 

Outpatient Programs

Outpatient programs are the least intensive level of care. Patients, at this point, must have a good amount of control over their eating disorder symptoms.

In the less intense form of outpatient care, a patient may have a regularly scheduled meeting with a therapist, psychiatrist, doctor, or other care team members, though otherwise live and sleep at home.

Those who want or need a little extra support can try an intensive outpatient program (IOP). This level of care is a hybrid between a day program and outpatient treatment, with sessions taking place several days a week for several hours at a time.

Maintenance or Post-Recovery Care

Even if you recover from anorexia nervosa and can adopt a healthier mindset about eating and weight maintenance, there is always the potential for backsliding and developing the symptoms of anorexia again. For example, it is relatively common for people who have had anorexia to still think much more about food and calories compared to someone who has not had the condition.³

For this reason, it is a good idea for people with AN to engage in regular therapy sessions at least twice a month. This post-recovery care can help people maintain their progress and is generally good for their quality of life. 

Depending on your needs, you may still want to talk to a therapist specializing in eating disorder care, or you may be able to transition to a general therapist.

Self-care

The most basic level of treatment for anorexia nervosa is self-care. This is when you either research basic mental techniques or learn them from a treatment professional and then use them daily to reduce symptoms. Recommended approaches can vary but generally involve identifying negative thought patterns and redirecting or refocusing thoughts more healthily. 

For example, changing what you classify as a “healthy weight” and learning how to have a healthy relationship with food rather than focusing on how to lose or avoid gaining weight.

Still, while self-care can help with learning strategies to maintain recovery, it is rarely recommended as a first option for anorexia nervosa treatment. AN rarely gets better without the help of a medical professional, so if you or a loved one are concerned about disordered eating behaviors related to anorexia nervosa, it’s crucial to seek out help.

Other Types of Anorexia Nervosa Treatment

Within the varying levels of care for anorexia nervosa, several different treatment options may help patients with different backgrounds and present needs.

Therapy

Once a patient is beyond immediate physical health concerns, therapy is generally the first line of care recommended for people with anorexia nervosa. And while no one approach has proven more effective than the rest, several types of therapy have been shown to help.²

Medication

No medication is currently approved to treat anorexia nervosa directly, and only a few medicines are notably helpful in treating other eating disorders (EDs). At the same time, research in this area is ongoing, so this may eventually change.¹

For now, medications can work as a supplemental treatment for AN. In this sense, antidepressants can be beneficial, as these medications can work to reduce symptoms of depression and other mental disorders that commonly co-occur with anorexia nervosa.

Like self-care, medication alone is not the recommended primary treatment for anorexia and is unlikely to lead to recovery. When used appropriately, however, and under a medical professional’s guidance, medications may help improve quality of life.

What to Look for in a Treatment Solution

The most important factor to consider when seeking treatment for anorexia nervosa is using evidence-based solutions. Unfortunately, some unscrupulous individuals may try to sell treatment options that aren’t based on scientific evidence and are unlikely to help you. Always seek treatment from mental health care professionals and facilities that are accredited and reputable. 

Be wary of any treatment option promising rapid results. Anorexia nervosa treatment takes time, and you may have to try multiple types of therapy before finding the best option for you. Guarantees of particular results aren’t possible with anorexia treatments, although it is possible to manage anorexia and experience sustained recovery effectively.

Will Insurance Cover Anorexia Treatment?

Anorexia nervosa is recognized as a legitimate mental health issue in the United States. The levels of care and types of treatment covered by insurance depend on a number of factors, including your specific insurance provider and plan and the severity of your eating disorder symptoms, among others.

Generally, securing coverage for residential care is more difficult due to the programs’ extended length and cost.⁴ While the regulations protecting coverage of inpatient care and similar treatment options have improved, you may still encounter issues and need to appeal an insurance provider’s decision if they deny admission. Even with coverage, some insurance plans may require you to pay more out of pocket than they would expect.

Insurance providers can further complicate matters by trying to dictate treatment options for patients even when the best option for a patient is a different option. However, getting coverage for regular therapy sessions is usually more straightforward. Most types of health insurance should also cover any medications prescribed to an individual for symptoms of AN in the same way standard medications are covered.

While there is certainly room for improvement in the current system and legitimate causes for complaints, many people can get coverage for anorexia treatments through their insurance with some amount of effort.

Taking the First Step Toward Recovery

If you’re seeking help for anorexia nervosa, the first step is often the most difficult. It is hard to admit that you’re struggling and need help from a medical professional.

Seeking any help from a reputed mental health professional or care team is an excellent way to begin. This first step can be challenging, but it’s very worthwhile. You can slowly adjust your treatment plan to best suit your needs. With the guidance of your therapist, you can find the treatment approach that works best for you.

Start by speaking to a mental health professional specializing in treating eating disorders. Depending on cost, availability, and insurance, you may first need a referral from a more general mental health care professional, but this is often easy to get. From there, the professional can work with you on developing a treatment plan to help you get healthier, both physically and mentally.