Bulimia Nervosa Treatment

Inpatient care is the most intensive type of treatment for bulimia nervosa, or other eating disorders like binge eating disorder (BED) or anorexia nervosa (AN). It involves a patient staying full-time at a treatment facility to receive 24-hour medical care and monitoring.

Inpatient hospitalization is generally reserved for the most severe cases. Patients receiving this type of care are nearly always experiencing some type of mental or physical health crisis or other serious health complications that could be an immediate threat to their lives. As such, stays are often short, with the overall goal of inpatient hospitalization helping someone become medically stable.²

Once someone has moved beyond the physical symptoms of immediate health concerns, they and their treatment team can begin considering more mental health-oriented and long-term goals. That’s the role of residential eating disorder treatment.

The schedule is also intensive, involving anything from individual and group therapy sessions, meal monitoring, medical check-ins, and nutritional counseling on a regular basis. However, the setting is much more relaxed and intended for longer-term stays, with most patients remaining in this type of care for a minimum of 30 days.²

Partial hospitalization programs (PHPs) are another intensive method for treating eating disorders. They often include similar treatment schedules to residential programs, though patients at this level of care are allowed to live and sleep at home, which is why PHPs are sometimes referred to as “day programs.”

But that doesn’t mean the schedule is restful. A PHP can last up to 5 days per week, for 10 hours per day, or sometimes more.² The extensive work being done still makes this a helpful level of care for those still experiencing severe disordered thoughts and behaviors, and sometimes those who could be recommended for residential care attend PHPs instead due to considerations around cost or familial responsibilities.²

Still, as someone progresses toward recovery, their schedules are usually adjusted to reflect the current amount of medical supervision they need.

Outpatient care is the least intensive form of care for bulimia nervosa. It often consists of a regular appointment with a mental health professional, like a therapist. It may involve regular check-ins with doctors or other treatment team members, especially if patients were prescribed medication as part of their care routine.

Otherwise, people at this level of care are living and sleeping at home and are generally able to perform their social responsibilities without struggling with their eating disorder symptoms.³

Those needing extra support at this stage may also benefit from an intensive outpatient program (IOP). This hybrid model involves treatment sessions that take place several times a week, for several hours at a time, but still allow for ample personal time when someone can practice new coping mechanisms on their own or continue going to work or school.³

Insurance is often the biggest concern for people looking for help. And there’s a good reason: Treatment can be expensive for those who aren’t covered.

It’s essential to get a formal diagnosis from a doctor before you consider enrolling in a bulimia treatment program. Without this diagnosis, it is unlikely that insurance will cover the cost of your care. With the diagnosis, your care is deemed medically necessary.

You should also check exactly what and how much treatment your plan may cover. Some insurance policies only pay for a certain number of treatment sessions or types of therapy considered “evidence-based.”

Contacting a representative from your insurance company could be a good first step to discuss these considerations and ask for the names of any doctors or programs in their network and, therefore, be more easily covered.

Your insurance company should work with you to cover your care. But you may still face unexpected expenses due to these issues:

• Limits: Your insurance plan could cap how long you can stay in treatment. And some cap on how much coverage you can use for any medical condition, including an eating disorder.
• Settings: Some insurance plans balk at inpatient care costs, and they entice members to move home as soon as possible. They may require you to attempt outpatient treatment before they cover the cost of inpatient care.
• Copayments: Some plans require you to pay a portion of your treatment costs. Paying a set amount each visit is common, and insurance will cover the remainder of the bill.
• Deductibles: Most plans require you to spend a set amount before they’ll pay anything. Once you hit this deductible amount, your coverage will kick in. 

All of these fees could make your bulimia treatment costs rise. Talk with your insurance company, doctor, and treatment team before care begins so you know what to expect. And if you see a bill you don’t understand, speak up right away. 

If the total still seems pricy, or if you don’t have insurance, you can also speak with the treatment center directly. They may have options to make the out-of-pocket cost of care easier for you to manage. Some centers offer payment plans where you can finance the cost of your care over time. You might not even have to begin making payments until you leave treatment.