Residential Treatment for Bulimia and Other Eating Disorders

Several levels of care have been developed to help people at all points of the recovery journey overcome these conditions. For those who struggle daily to keep their disordered thoughts and behaviors under control, residential eating disorder treatment may be a helpful choice for moving forward with the healing process.

What is Residential Eating Disorder Treatment?

Residential eating disorder treatment is an intensive level of care for people with these conditions. It involves living full-time at a treatment facility, where patients follow a daily schedule that involves several types of treatment.

At this level of care, patients usually work on several facets of recovery, including understanding what drives their eating disorder and learning new, healthier coping skills. They typically work with a treatment team that can include nurses, physicians, specialists, and other medical staff with expertise in a range of areas.

Residential treatment programs are generally longer-term, lasting 30 days or more.¹ As such, facilities are usually more home-like, and the environment is more comfortable than clinical. Treatments are also often tailored to establishing or reaching longer-term recovery goals.

Eating Disorder Residential Treatment vs. Inpatient

Many people confuse residential treatment with inpatient treatment for eating disorders. While residential treatment is technically a form of inpatient care, as patients live full-time at treatment centers, “inpatient” care is usually much more intensive.

Sometimes also called inpatient hospitalization, this level of care is reserved for the most severe cases or circumstances when a patient is considered at risk of immediate death or otherwise medically unstable.¹

During inpatient hospitalization, a patient stays at a hospital full-time, where they can receive 24-hour medical care and observation. Treatment is usually shorter-term and focused on helping a patient become medically stable, at which point they can transfer to other levels of care, including residential treatment.

Eating Disorder Residential Treatment vs. Outpatient

On the other end of the spectrum, outpatient care is less intensive than residential treatment for eating disorders. Still, there are several levels of care where patients live at home and commute to treatment.

Partial hospitalization programs (PHPs) are the most intensive type of outpatient care. They require patients to attend treatment for many hours every day, most days of the week. Sometimes, those who don’t qualify for residential treatment may enroll in a PHP instead.

Intensive outpatient programs (IOPs) are a step down from PHPs. At this point, patients attend treatment several days a week, with sessions lasting a few hours each. IOPs are a good in-between point for patients ready to incorporate social responsibilities into their recovery efforts.

Standard outpatient treatment is the lowest level of care. It usually involves a weekly or otherwise regular appointment with a therapist and occasional check-ins with psychiatrists or primary care physicians. At this point in treatment, patients should have their disordered thoughts and behaviors well under control and be able to resume their social roles while maintaining recovery.

Types of Treatment at Residential Eating Disorder Programs

Each residential program will be different, depending on the specifics of the treatment center and the patient’s needs. But in general, most programs have patients follow strict daily schedules that include several types of ongoing treatment, including:

• Individual therapy: These sessions help a patient understand what drives their eating disorder and may teach them healthier ways to cope with stress. Some of the most common methods of individual therapy for eating disorders include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).
• Group therapy: Patients engage in therapy with others who are going through similar experiences. This can help give them a different perspective on their struggles and make them feel less alone.
• Nutrition counseling: Patients usually have a very damaged relationship with food. Nutrition counseling helps them establish a healthy relationship with what they eat, their bodies, and their self-image.
• Meal support: Meal planning is common at this level of care, though patients who still struggle with disordered thoughts may have a hard time eating what’s in front of them. Staff members will sit with them through these meals to offer company and support during what can be an uncomfortable time.
• Medical support: Regular check-ins with medical staff are common at this level of care. Patients may have their weight and vital signs tracked; some may also meet with psychiatrists or other medical specialists.

Some residential treatment programs offer other care options, such as art therapy, yoga, or equine therapy. Depending on the program, patients may also have time off in the evenings or be allowed to have family or friends visit on certain days.

Benefits of Eating Disorder Residential Treatment

Attending a residential eating disorder treatment program may seem like an intensive step, but it can have many benefits.

Patients who are having a tough time with their thoughts and behaviors will have access to 24-hour care and be given plenty of time and opportunities to work on many aspects of their illness. The immersive quality of the programs can also be helpful for those who come from particularly unstable homes or struggle with many triggering situations at home.

Most importantly, this level of care generally creates results. Studies have shown that residential programs for eating disorders frequently lead to positive progress for patients, including weight recovery or stabilization and improvements in co-occurring depression and anxiety.²

Who is Residential Treatment Best for?

Residential care is an excellent choice for many patients, but it’s not for everyone.

This type of intensive treatment is best for those who have struggled with their disorder for a long time and have not been able to make progress with other types of care or those who struggle every day with their disordered thoughts and behaviors. It’s also a good choice for patients who want or need a break from the stressors of their daily life to focus on recovery.

Still, residential treatment can be pricey. Major insurance companies may decline to cover this type of care or only partially cover it. Being away from home for long periods can be difficult for younger or older patients with other social and family responsibilities.

It’s best to consult with your doctor or therapist to determine if a residential eating disorder treatment program is the best step for you.

Choosing the Right Residential Eating Disorder Program

If you or a loved one are struggling with an eating disorder, looking into treatment programs may feel like the last thing you want to do. And once you start researching different treatment centers, the number of options can feel overwhelming.

One of the best ways to narrow the field is to consult your health insurance company. A representative can tell you about programs that are more likely to be covered by your plan. This can help you understand how much a program will cost, eliminate surprise bills, and avoid having to change centers mid-treatment for financial reasons.

Of course, there may be other aspects of a program you prioritize, including the types of treatments available, a center’s general philosophy, or even specific doctors you want to work with.

Asking these questions of your treatment provider can help you make the most informed choice possible for you or your loved one. Hopefully, it represents the first step toward a more long-term, robust recovery and a healthier future.