Levels of Treatment for Anorexia

There are many levels of anorexia nervosa treatment. Often, the best way to begin is by talking to an eating disorder specialist and determining what kind of therapy will work best for your health and circumstances.

Patient with a doctor

If symptoms are severe enough, a temporary stay at an inpatient facility can greatly improve physical and mental health and long-term outcomes.

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 they are generally about identifying negative thought patterns and redirecting or refocusing thoughts in a healthier way. 

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 weight or how to avoid gaining weight.

While practicing self-care can be legitimately helpful when dealing with almost any mental health issue, including eating disorders, self-care alone is not the recommended primary treatment for anorexia. It is unlikely to lead to recovery or a significant reduction in symptoms

Medication

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

For now, medications can work as a supplemental treatment for anorexia. Medications like antidepressants are sometimes able to reduce symptoms and address co-occurring disorders. People with anorexia often suffer from other mental disorders, such as severe anxiety, depression, and obsessive-compulsive disorder. 

Like self-care, medication alone is not the recommended primary treatment for anorexia and is unlikely to lead to recovery. When used appropriately, medications can improve your quality of life.

Therapy

Therapy treatments are the first type of care on this list that research indicates can effectively treat anorexia nervosa. [2] Many different therapeutic approaches may help with anorexia. There isn’t solid evidence that one singular approach is better than the rest. 

Often, the recommendation is that you start by trying cognitive behavioral therapy (CBT), which focuses on targeting the distorted way of thinking (e.g., a fear of gaining weight) that can lead to the more destructive elements of anorexia. Ultimately, CBT can help reduce anorexia nervosa symptoms. 

Family therapy is also an important aspect of eating disorder treatment. Family members need to be educated on supporting their loved ones during recovery, which can be crucial for long-term success.

Day Treatment or Intensive Outpatient Program

Day treatment shares many similarities with standard therapy but is more intensive. You’ll often see a medical professional or team of medical professionals multiple times per week. In addition, part of the treatment 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. 

Day treatment is often part of the transition from emergency inpatient care to a more regular therapy treatment regime. 

Inpatient Care or Hospitalization

Inpatient care or outright hospitalization is generally what would be considered the most intensive level of treatment on this list. This type of treatment involves staying overnight, generally for multiple days, at a treatment facility. 

It is usually an option for those with severe anorexia and who may be struggling with serious medical complications due to malnutrition. It may also be appropriate for people who want to get help for anorexia but still have such extreme levels of anxiety around eating and weight gain that they find it difficult or impossible to function in their day-to-day life. 

Inpatient care is usually somewhat scheduled—you’ll receive counseling and medical treatment for any issues with your physical health. This level of care is exclusively temporary. The goal is to provide you with enough support to safely transition to a more autonomous lifestyle with healthier eating habits.

The length of this type of care varies, although it’s rare that a program lasts longer than two months. Programs often last about a month.

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 who have had anorexia to engage in regular therapy sessions at least twice a month. 

This post-recovery care can help a person maintain their progress. It is generally good for your quality of life to talk with a mental health professional regularly. 

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. 

Identifying the Level of Care Best for You

The initial level of care that best suits your needs is likely either therapy or a more intensive day treatment program. These treatment options have enough evidence suggesting they can be successful while allowing you to perform essential life tasks, such as working or going to school. 

Often, the best way to begin is by talking to a mental health professional about your symptoms and concerns. They can then guide you to the best level of care for your needs.

With the above in mind, inpatient care or hospitalization may be temporarily necessary if your symptoms are severe, especially if you feel your life is in danger. Keep in mind that inpatient programs are in no way meant to punish you for any perceived failing. Instead, they are to provide a level of intervention and support that is not possible with outpatient care, so you have the best chance of recovery.

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 treatment takes time, and you may have to try multiple therapy types before finding the best option. 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?

Insurance can cover anorexia treatment, although coverage complications are somewhat common for inpatient programs, which can be long-lasting. [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.

Usually less complicated is getting coverage for regular therapy sessions, with insurance providers treating this care as they would for any other mental health issue. Most types of health insurance should also cover any medications prescribed to an individual for symptoms of anorexia in the same way standard medications are covered.

Anorexia nervosa is recognized as a legitimate mental health issue in the United States. But unfortunately, many don’t realize their insurance covers care for these issues even when it does. 

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. 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 enough 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 have an unhealthy relationship with food and a distorted body image and to seek help for those issues from a mental health professional.

Seeking any help from a reputed mental health professional or care team is an excellent way to begin. [5] This first step can be challenging, but it’s very worthwhile. You’ll find that 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 your 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.

Resources


  1. Gorla K, Mathews M. (2005). Pharmacological Treatment of Eating Disorders. Psychiatry (Edgmont); 2(6):43-48. 
  2. Kass AE, Kolko RP, Wilfley DE. (2014). Psychological treatments for eating disorders. Current Opinion in Psychiatry; 26(6):549-55.
  3. Anorexia. (2020). National Library of Medicine. (2020, May). Retrieved August 21, 2022.
  4. Gordon D. (2021). Despite Progress, Patients Still Struggle With Insurance Coverage For Eating Disorder Treatment. Forbes. Retrieved August 21, 2022.
  5. National Collaborating Centre for Mental Health (UK). (2004). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. Leicester (UK): British Psychological Society (UK); (NICE Clinical Guidelines, No. 9.) 6, Treatment and management of anorexia nervosa.

Last Update | 11 - 8 - 2022

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