How Outpatient Therapy Is Used for Eating Disorders

Teen in therapy session
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Many people suffering from eating disorders—including anorexia nervosa, bulimia nervosa, and binge-eating disorder—can receive outpatient treatment. Others may begin their treatment journey instead in an inpatient treatment program or in any of a number of levels in between. There are several reasons that people with eating disorders may need a higher level of care at some point in their recovery journey including medical instability, suicidality, and need for more structure and support around meals.

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Outpatient treatment is the most flexible level of care for eating disorders, and it's the level of care offering the least disruption of your regular day-to-day life. It's also usually the most cost-effective. You can keep up with school, work, and other commitments while attending treatment appointments.

What Happens in Outpatient Eating Disorder Treatment?

The cornerstone of your treatment plan is usually individual counseling sessions. On an outpatient basis, your psychotherapy typically occurs at least once a week, with each appointment lasting about an hour. However, depending on your individual needs and the severity of your eating disorder, your therapist may recommend that you attend sessions more frequently.

As treatment progresses and you need fewer sessions, your therapist will likely recommend spacing sessions out to every-other-week, and then to once-per-month and eventually to an as-needed basis.

Many people also attend family therapy sessions as part of their eating disorder treatment. Your primary therapist may coordinate these sessions, or you may also have a separate family therapist on your treatment team.

Your age (adolescent or adult), how far away your family lives, and how involved you are with your family are all factors that will help determine whether these sessions are scheduled regularly or interspersed throughout treatment. If you have a spouse or significant other, he or she may also be encouraged to take an active role in your treatment.

Other Types of Therapy

Group therapy or support groups are also very common for those in outpatient treatment. However, it's important to talk with your primary therapist about when it would be appropriate to start a group and what group she or he would recommend if that is something you are interested in. Group therapy can be extremely beneficial in treatment. However, it can also be overwhelming and be triggering to someone who is new to recovery.

Nutrition counseling or consultation with a dietitian is typically recommended as part of outpatient treatment as well. These appointments typically last thirty minutes to an hour and may occur every week or less frequently. They encompass nutrition education, meal planning, and accountability for your meals.

Many clients initially shy away from making appointments with dietitians, thinking that they will force you to eat more (or less) than you are comfortable with. However, most dietitians who specialize in working with people who have eating disorders are very patient and able to move at a pace you are comfortable with.

Regular physician visits are also extremely important for anyone suffering from an eating disorder. Your physician will be able to assess if you are experiencing any medical complications from your disorder and can determine if you need a higher level of care with additional medical monitoring. Many sufferers also see a physician who specializes in mental illnesses, a psychiatrist. This is the person who will prescribe and monitor any medications to help with the symptoms you are experiencing.

Who Should Get Outpatient Therapy?

If you don't have any medical complications that need to be monitored, and if you're able to make progress on an outpatient basis, then outpatient therapy for eating disorders may work well for you.

For instance, if you're able to follow a meal plan with only the support of your family, then outpatient treatment may be a good fit. However, if you aren't able to follow a meal plan at all, or you have medical complications or also suffer from depression, a higher level of care may be more appropriate.

Most people suffering from an eating disorder use outpatient treatment options at some point in their recovery. They may only be treated on an outpatient basis or they may attempt recovery on an outpatient basis only to decide later that a higher level of care is necessary.

Even people who are treated at a higher level of care typically continue treatment on an outpatient basis after they complete work with the additional support of intensive outpatient, inpatient or residential treatment, so you (or your family member) likely will be treated on an outpatient basis at some point during recovery.

By Susan Cowden, MS
Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders.