Eating Disorders Treatment Hospitalization for Eating Disorders By Susan Cowden, MS Susan Cowden, MS Facebook LinkedIn Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders. Learn about our editorial process Updated on March 19, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Rafal Rodzoch / caiaimage / Getty Images Table of Contents View All Table of Contents Overview Hospitalization Considerations Timing for Hospitalization Residential Treatment Centers Full Continuum of Care Eating disorders can be extremely dangerous and potentially deadly illnesses. People with eating disorders frequently experience medical complications, which can affect all systems of the body. As a result, sometimes people with eating disorders, including anorexia nervosa and bulimia nervosa, may require treatment in a hospital or residential treatment center (RTC). Both inpatient hospitalization and residential treatment centers for eating disorders provide patients with additional support, structure, medical care and monitoring. It may be helpful to understand what will happen in these settings for an eating disorder. Overview Inpatient hospitalization is the most intensive level of treatment. The main reason for inpatient hospitalization is medical instability. As a result, eating disorder patients needing inpatient hospitalization are often admitted to specialized units rather than general psychiatric units where patients with other mental disorders are usually treated. Whenever possible, eating disorder hospitalization should take place in a specialized unit for eating disorders versus in a general medical or psychiatric unit. Eating disorders require a unique collaboration between many medical and mental health specialists and general hospital units may not be set up to provide the appropriate care. Hospitalization Considerations Because hospitalization is very expensive, it is usually short-term. Many patients only stay at the inpatient level of care until they have been medically stabilized enough to continue treatment at a lower level of care. The medical management available at the inpatient level is very important. Many patients require monitoring of vitals, intravenous fluids, tube feeding, medication, and laboratory tests. Patients are monitored by round-the-clock nursing staff. The inpatient hospital treatment team will usually consist of physicians, psychiatrists, therapists, dietitians, and nursing staff. It may also include other specialists if needed. Inpatient units are often connected to or affiliated with a full hospital which can provide access to different medical specialists, including cardiologists, neurologists, gastroenterologists, etc. Hospital staff also will provide basic nutrition information and nutritional counseling, and a dietitian will plan meals. If the patient can't eat enough to regain or maintain weight, doctors and other treatment team members may recommend medical refeeding, which involves inserting a tube through the patient's nose down into the stomach. This tube then can carry nutrition directly to the stomach. Medical refeeding is one of the unique services that inpatient hospitalization is able to provide. Another form of support that inpatient hospitalization is able to provide is supported meals. Staff members will typically supervise all of a patient’s meals to provide support and monitor intake. They will be available before and after meals, to process any urges that patients are experiencing and to support patients during these anxiety-provoking times. Hospitalized patients will also receive counseling with a therapist and an evaluation by a psychiatrist. Timing for Hospitalization Any time a person is experiencing medical complications due to their eating disorder including but not limited to an unstable heart rate or blood pressure, fainting, or bleeding from vomiting, they should be screened for hospitalization. Patients may require hospitalization if they are severely malnourished and/or have lost a great deal of weight and are at risk for refeeding syndrome. Although hospitalization can be scary, it is also a very necessary component of treatment for many people. If your therapist, physician or dietitian is recommending hospitalization, please go. It may save your life. Choosing not to go to the hospital when needed can be extremely dangerous. Patients may often be transferred to residential treatment or a partial hospitalization program when their vitals are stable, they have resumed some eating on their own with structure, and they have gained some weight. They may still require high levels of support and structure, but this can usually be provided at a nonmedical residential treatment center or a partial hospitalization program, which a patient attends during the day, but returns home at night to sleep. Residential Treatment Centers Residential Treatment Centers also house patients 24 hours a day, but these are non-medical facilities that provide housing, meals, and multidisciplinary treatment. Residential treatment is appropriate for patients who are medically stable but need full supervision to address eating disorder symptoms, such as vomiting, excessive exercise, laxative use, and dietary restriction. It can also be appropriate when someone is suicidal (although if there are any imminent concerns for suicide, this is an indication for inpatient hospitalization), if the patient lives far away from treatment providers, if there is a lack of social support, or if there are other complicating medical or psychiatric factors. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. The goal of residential treatment is to improve physical and psychological health. The average length of stay in a residential treatment center is 80 days. Patients receive supervised meals. Intensive psychotherapy, or counseling, is usually a routine part of residential treatment. Because patients are at residential treatment centers 24 hours a day, seven days a week, patients may be able to have sessions with therapists more frequently than on an outpatient basis. In some centers, they may be able to meet with their individual therapist several times during the week. They will also usually attend group therapy sessions and family therapy sessions. Full Continuum of Care The full continuum of care for eating disorders includes outpatient care, intensive outpatient programs (IOP), day treatment or partial hospital programs (PHP), residential programs, and inpatient hospitalization. A patient may move in either direction through the varying levels of care based on factors including symptom severity, medical status, motivation, past treatment history, and financial abilities. 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. MedlinePlus. Eating Disorders. November 8, 2019. ScienceDirect. Specific Mental Disorders: Eating Disorders. National Association for Anorexia Nervosa and Associated Disorders. Inpatient/ Hospital Treatment Programs. McLean Hospital. Klarman Eating Disorders Center. By Susan Cowden, MS Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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