Living With Food: The Science Supporting Eating Disorder Treatment

Not everyone will get better from their eating disorder from only individual or family therapy. Part of the unfortunate truth about eating disorders is that it is hard to truly recover and stay recovered. For many people, more intensive treatment than weekly visits is necessary. This is not an indication that someone has failed therapy or that someone is not trying hard enough to get better, rather is speaks to the intensity and severity of the illness.

When you’re only in therapy an hour a week it means there are 167 hours per week that you need to manage on your own. Often times this is not a sufficient amount of support.  In order to move fully to a path of recovery, higher levels of care provide multiple interventions to make recovery both more likely and more sustainable. First, it increases the amount of time that a person has contact with a supportive and therapeutic environment, as our higher levels of care may be anywhere between 10 and 35 hours per week. Additionally, reinforcement and support can be incredibly helpful to maintain healthy behaviors and stay on a better path in terms of thoughts and feelings.  Higher levels of care may also offer multiple opportunities to eat with others, which helps to ensure the diminishment of overall behaviors and increase skills in managing eating. Higher levels of care provide increased amounts of therapy, specifically cognitive behavioral and dialectical behavioral therapy, to increase skillfulness in life and around eating disordered urges. A higher level of care also allows the individual to become part of a group, to share their experiences in a larger setting, to learn from others who are having similar experiences, and to gain strategies and feedback about how to manage their own disorder and to feel less alone with an illness that tends to isolate.

When one enters a higher level of care it is difficult to know how long treatment at that level will be necessary. Issues including behaviors, weight, medical complications, external supports, other psychiatric issues, and real life considerations will all impact on length of treatment. A higher level of care should be thought of as one stage in a lengthy process of recovery that will likely require treatment before, treatment after, and the building of a healthy community to last a lifetime.

Contributions by Sarah Emerman