Living With Food: The Science Supporting Eating Disorder Treatment

By, Dr. Mark Warren

At CCED, our focus is to provide care to clients both in our local community and those who may benefit from Dialectical Behavioral Therapy and Maudsley Family Therapy. In both cases patients live at home or with family while they are receiving care with us. It is our experience for the large majority of patients with eating disorders that care can be provided in the outpatient setting with a high degree of effectiveness. However, in some situations higher levels of care including residential and inpatient treatment are necessary.

For patients that require this care, choosing which facility to use becomes extremely important and may be quite complex. To make this decision there are several factors that may be considered. For almost everyone, insurance will be an issue. Residential care is usually quite costly and access to insurance coverage to help off set the cost is one of the single greatest factors in choosing which facility you will use. In addition to cost, questions of which type of care is going to be the most effective is also a core issue. For adolescents, given CCED’s orientation to Family Based Treatment, our tendency is to favor those programs that have as much family involvement as possible during the residential or inpatient stay of your child. We also give preference to programs that stress weight gain when necessary, extinguishing behaviors, and development of balanced eating patterns that can be continued after discharge. For adults, CCED will refer to programs that fully incorporate evidence based care, including CBT and DBT. We recommend facilities where the primary emphasis is on the need to gain appropriate weight if needed, and stop life threatening behaviors. We have had experience with referrals to multiple residential centers, and if it seems that residential care is needed, specific recommendations can be made.

For some patients, inpatient care followed by partial hospitalization may be preferred to residential care. Usually the factors that drive inpatient rather than residential are medical complications, and/or the need to be medically monitored during stages of refeeding.

For all patients, our belief is that the establishment of balanced eating patterns, gaining weight appropriately, and extinguishing eating disordered behaviors are the core of achieving long term success and recovery from an eating disorder. Good residential and inpatient care is sometimes an important step in this recovery process.

Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman