Eating Disorder Hospitalization & Inpatient Treatments

What Is Inpatient Treatment?

Inpatient treatment refers to receiving 24/7 medical services within a psychiatric unit or psychiatric hospital that treats eating disorders. In addition to medical management, such as electrolyte and fluid supplementation, treatment can also include case management, nutritional support, individual and family therapy, and clinical groups. After inpatient treatment, patients may transfer to residential treatment facilities or outpatient care.

Residential Treatment

Residential treatment refers to comprehensive treatment where clients live in a home-like setting and receive clinical and medical services. Eating disorder inpatient treatment typically consists of medication management, nutrition education, supervised meals, group therapy, individual therapy, case management, and family support. Program lengths can vary and in some severe situations, patients may have 1-6 months of inpatient care.

What Is Hospitalization?

Medical hospitalization provides acute care for eating disorders. This type of inpatient treatment is typically reserved for severe symptoms, including malnutrition, electrolyte disturbances, dehydration, hypothermia, severe hypotension, and orthostatic changes in pulse and blood pressure. Minors who refuse to eat food may also be admitted to the hospital.¹

Inpatient & Hospitalization for Eating Disorders

Hospital and inpatient treatment may be necessary for initial medical stabilization. Hospitalization is not always necessary, but severe medical or psychiatric issues, including suicidal tendencies, may warrant the need for such monitoring. Inpatient treatment is typically recommended if the individual needs ongoing medical stability, supervision, and nutritional support.

Inpatient Treatment for Eating Disorders

Inpatient treatment may be utilized for treating health consequences of a variety of eating disorders, including anorexia,  bulimia, and binge eating disorder. Therapy is a significant component of eating disorder treatment, and it’s common for facilities to implement an integrative clinical approach within their care. Some types of therapy you might receive include enhanced cognitive behavior therapy (CBT-E),dialectical behavior therapy (DBT for eating disorders), exposure therapy, acceptance and commitment therapy, and experiential therapies.

The length of treatment varies depending on the individual’s age, presenting issues, health status, and previous treatment episodes. One study found that the average length of patients receiving inpatient care for anorexia is 76.3 days.² People using health insurance to pay for treatment may be constricted by their health insurance’s authorization when it comes to the length of their treatment.

A typical inpatient treatment program may include the following:

• A physical and mental health care team: Eating disorder treatment teams can consist of therapists, psychiatrists, social workers, and registered dietitians. This team works together to coordinate care and support the patients toward achieving their treatment goals.
• Medications: It’s estimated that anywhere from 55-97% of people with eating disorders also have another psychiatric condition, including mood disorders, anxiety disorders, PTSD, personality disorders, and substance use disorders.³ Medication may be recommended to treat symptoms of any of these conditions, which may, also reduce eating disorder behaviors.
• Group therapy: Group therapy for eating disorders can be a component of inpatient treatment.  Groups might cover numerous topics, including self-esteem, boundaries, trauma recovery, nutrition, coping skills, and relapse prevention.
• Aftercare: Inpatient treatment is not always enough to sustain recovery long-term. However, after inpatient care, plans are made for continued outpatient management.
• Supervised meals: Inpatient treatment may include guidance with meal selection. Patients receive comprehensive nutritional assessments and may adhere to various meal plans provided by their dietitian.

Residential Treatment for Eating Disorders

Residential treatment for eating disorders consists of multidisciplinary care for people of all ages and demographics. Some treatment centers also offer specific programs for people experiencing other issues, including substance use disorders. Patients attending residential treatment live in a home-like setting with supervision throughout the duration of their care.

Residential treatment in home-like settings tends to be longer than inpatient treatment in psychiatric hospitals. In general, residential treatment does not involve treatment for medical issues, such as seizures or other complications. Residential care settings can last between 1-6 months.

Hospitalization for Eating Disorders

Eating disorders can be associated with psychiatric emergencies and can sometimes lead to medical emergencies. Hospitalization may be necessary for people with acute medical or psychiatric concerns. The goal of hospitalization is to accomplish medical stabilization.

People may be hospitalized for many reasons, including severe dehydration and electrolyte imbalances, coughing up blood, bloodin the stool, seizures, loss of consciousness, co-occurring substance use, suicide threats, and the need for ongoing medical monitoring. The assigned medical treatment team will establish when the individual is ready to be discharged from the hospital.

A typical hospitalization stay may include the following:

• Medical refeeding: Medical refeeding provides a safe reintroduction to food when the body is malnourished. Monitored medical refeeding may help reduce the risk of refeeding syndrome.⁴
• Supported meals: Hospitalization entails supervised meals.
• Dietitian: Dietitians will assess baseline nutritional needs for patients during the hospital. They will use this information to implement an initial meal plan.
• Medication: Sometimes medication is prescribed to stabilize acute medical or psychiatric conditions. Depending on the specific reason, these medications may be prescribed either short-term or long-term.

Eating Disorder Hospitalization & Inpatient FAQs

Individuals and their loved ones often feel overwhelmed when navigating various treatment options for eating disorders. This section is intended to provide you with a brief overview of some of the most commonly asked questions about inpatient treatment and hospitalization. With that, it’s important to remember that treatment is not a one-size-fits-all, and each person’s goals will be specific to their situation.

How Long Will I Have to Stay in the Hospital?

There is no definitive answer. Treatment varies from patient to patient, and numerous factors, including current health status, age, psychiatric concerns, and responsiveness to treatment will influence the length of care. In most cases, the actual hospitalization experience is shorter than inpatient, residential, and outpatient care.

Does Insurance Cover Hospitalization for Eating Disorders?

Some healthcare providers provide some coverage for different mental health services. These limits vary based on your specific insurance plan. Your cost will also depend on your current premium, deductible, and whether you choose to use an in-network provider for hospitalization care. It’s important to contact your insurance company directly to address coverage concerns.

How Do I Choose Between Inpatient or Outpatient Treatment?

Some facilities offer both inpatient and outpatient treatment programs. If you are interested in a particular program, their mental health professionals will perform a thorough assessment to determine the best level of care for your needs.

Will I Have a Feeding Tube?

Some clients with severe malnutrition or restrictive eating disorders may need placement of an nasogastric tube for nutrition (also known as a feeding tube).It can provide people with the ability to safely and slowly eat normally again, and it can help mitigate the risk of reinforcing overeating.⁵

Will My Eating Disorder Treatment Be Confidential?

All healthcare providers must abide by their board of laws and ethics when it comes to adhering to client confidentiality. In most cases, your medical information is protected and held confidentially. There are exceptions for reports of child, elder, or dependent adult abuse as well as being in acute danger of hurting yourself or someone else.

What If I Don’t Feel Ready For Treatment?

It’s normal to experience ambivalence or resistance about seeking treatment, especially if you have had ups and downs with your recovery in the past. It’s important to remember that recovery isn’t necessarily linear. With that said, most people feel significantly better when they reduce or eliminate their most debilitating eating disorder symptoms.

How Effective Is Eating Disorder Treatment?

Eating disorders are complex conditions, but research shows that clinical treatment can be beneficial for reducing associated behaviors. For instance, interpersonal therapy, family therapy, CBT, DBT, and adaptations of CBT specifically for eating disorders are all evidence-based.⁶ Effectiveness will vary based on individual symptoms, other co-occurring conditions, and aftercare support.

Eating Disorder Hospitalization Admission Procedures

People are typically admitted to the hospital after an assessment. This assessment consists of numerous diagnostic tests, including an individual’s self-report, collateral information from family members (particularly if the client is a minor), blood work, vitals, and any referring data from the client’s primary care physician.

Hospitalization includes regular care and supervision. During this time, there will be ongoing monitoring.Clients will receive supervised meals and psychological support throughout their stay.

What Are the Costs of Hospitalization & Inpatient Eating Disorder Treatments?

Hospitalization and inpatient eating disorder treatment programs can cost thousands of dollars a day if paid for out-of-pocket. Some locations offer sliding scale or scholarship opportunities to those in need of financial assistance. An individual’s health insurance may also subsidize or cover costs when the services are deemed medically necessary.

Costs of Inpatient Facilities

Inpatient facility costs vary, but people can spend anywhere from $15,000-$75,000 per month for inpatient treatment. Costs vary based on the specific facility amenities and the total length of stay- as well as any medications, additional appointments, and clinical services. Most people use their health insurance to subsidize some or all of their inpatient treatment costs.

Costs of Residential Facilities

Like inpatient treatment, residential programs can also be quite costly. However, many people use their insurance to pay for some or all of their treatment. It’s important to check with your insurance to determine which type of coverage they provide and what costs you might still need to account for.

Costs of a Hospital Stay

Hospital stays for eating disorders are typically shorter than inpatient or residential treatment. However, hospital costs can be expensive (more than $1000 per day), and it’s important to determine the specifics of your insurance coverage. With that in mind, Insurance will only cover hospitalization if the services are deemed medically necessary.

Pros & Cons of Eating Disorder Treatment Options

All eating disorder treatment options have their benefits and drawbacks. In addition, it can be difficult to know which choice is the best option for you or your loved one. It’s important to do your best to make an informed decision before pursuing any specific treatment. With that, remember that seeking care- even if it feels too early- is rarely a bad decision.

Inpatient Hospitalization Treatment

Inpatient treatment can be beneficial for people who cannot recover on their own or who live in an unsupportive or unstable home environment. Inpatient treatment is in the hospital for more than 24-hours. This treatment is valuable when there are acute medical concerns. However, inpatient care can be cost-prohibitive. It also may require significant travel/disruption of life activities.

Possible pros of inpatient treatment include:

• Receiving immediate and ongoing support
• Access to nutritional guidance
• Medical stabilization

Possible cons of inpatient treatment include:

• The cost
• Lack of available resources in certain areas/populations
• Need to plan for childcare, work leave, other daily disruptions

Residential Treatment

Residential treatment can provide a comfortable environment for people to understand their eating disorders and learn to manage their symptoms. This can set the foundation for a meaningful recovery. However, these programs can sometimes feel isolating, and people may feel jarred when they move back into the ‘real world’ after discharging.

Possible pros of residential treatment include:

• Group community
• Ongoing daily structure
• Comprehensive clinical services
• Supportive, recovery-oriented environment

Possible cons of residential treatment include:

• Expensive
• Limited interaction with family members/outside world
• May feel unrealistic to maintain recovery strides once back home
• May feel difficult if patient is not ready/wanting treatment

What to Expect After Eating Disorder Treatment

Eating disorder treatment can be long-term, as symptoms may ebb and flow in severity. Most people benefit from having ongoing therapy and nutritional guidance after completing a structured program. Having this support provides a roadmap for navigating stressors in daily life. It can also offer a sense of accountability during challenging times.

Creating a Relapse Prevention Plan

It’s essential that people with eating disorders can identify their triggers and learn new ways to cope with them. This specific type of insight can take time to develop (and new triggers may emerge at any given time). Ultimately, relapse prevention entails choosing healthier coping strategies and being mindful of the slippery slope of eating disorders.

When to Seek Professional Help for Eating Disorders

Eating disorders can be tremendously challenging for individuals and their loved ones. Without treatment, they can worsen progressively over time. This can lead to serious emotional, physical, and psychological consequences. Although treatment can feel frightening, it may be the most important gift you give yourself if you are struggling with your eating disorder.

The first step is reaching out for help. There are numerous treatment options, including online eating disorder therapy platforms like Within Health Online for virtual partial hospitalization and intensive outpatient treatment. An online therapist directory can be a helpful resource for finding a therapist who can help recommend inpatient care or hospitalization if necessary.