Choosing Therapy’s Scoring Criteria for Online Eating Disorder Treatment Programs

Millions of people are affected by eating disorders, which have some of the highest mortality rates among mental illnesses. Despite this, many individuals never seek treatment. In some cases, individuals who don’t require support provided by a higher, in-person level of care could benefit from online, at-home treatment; however, it’s crucial to guide patients toward effective, reliable, and safe resources. Choosing Therapy aims to identify platforms that provide exceptional services, providers, and care, as well as those lacking essential support.

Ideal care should include individualized treatment plans, the option for virtual intensive outpatient programs (IOP), the ability to treat co-occurring mood and anxiety disorders, and support for families and alumni.

Below you’ll find a list of our online eating disorder treatment scoring criteria, which includes stand-out services and features that contribute directly to a patient’s success in treatment. You’ll also see a breakdown of how each category is scored in our star-rating system.

Eating Disorder Treatment Options

Eating disorders are often resistant to treatment, making the search for effective solutions vital. Ideally, comprehensive online treatment should employ evidence-based programming to address a wide range of eating disorders, including anorexia, bulimia, diabulimia, avoidant/restrictive food intake disorder (ARFID), compulsive overeating, binge eating disorder, and other specified feeding and eating disorders (OSFED).

Effective treatment is never one-size-fits-all. It should encompass psychotherapy, medical care, monitoring (e.g., blind-weight scales, blood pressure cuffs, eating disorder recovery apps, etc.), nutritional counseling, medications for additional symptoms (such as insomnia or nausea), or a personalized combination of these services. Care should be provided by a multidisciplinary team of licensed clinicians, therapists, and prescribers with extensive backgrounds in eating disorder recovery. This team should offer specialized treatment for all age groups, recognizing that disordered eating can affect individuals at any stage of life

Prior to treatment, patients should undergo a comprehensive evaluation to determine if intensive outpatient programming (IOP) is suitable. If IOP is appropriate, the program should be readily available. In general, treatment plans should include a structured schedule of video appointments, and staff should be available via text or phone; companies must also have a crisis management plan in place for emergencies.

Star Ratings for Eating Disorder Treatment Options

5-stars – The company has established an online treatment program that meets the highest standards of care for those suffering from eating disorders, regardless of age. They employ evidence-based programming to address a wide range of eating disorders. Their approach and capabilities ensure that every patient receives the highest level of care tailored to their specific needs, integrating some combination of psychotherapy, medical care, monitoring, nutritional counseling, and medication-assisted treatment. Their team, made up of licensed clinicians, therapists, and prescribers, has extensive experience in eating disorder recovery.

Before beginning treatment, each patient undergoes a thorough evaluation to determine subsequent treatment plans, including the option of intensive outpatient programming (IOP). All treatment plans include a structured schedule of video appointments, and access to staff via text or phone, providing consistent and convenient access to services, as well as a robust crisis management plan to handle any emergencies that may arise.

3-stars – The company has met some, but not all, of the standards for an effective online treatment program. For example, they provide evidence-based programming and psychotherapy to address eating disorders; however, their services do not encompass the full spectrum of eating disorders, such as diabulimia, avoidant/restrictive food intake disorder (ARFID), compulsive overeating, binge eating disorder, and OSFED. OR, they do not offer intensive outpatient programming (IOP), though their treatment plans do include a structured schedule of video appointments. Perhaps, while they may meet all other standards of care, it remains unclear whether their clinicians and therapists have specialized backgrounds in eating disorder recovery, or whether they treat patients of all ages.

1-star – In our opinion, the company’s eating disorder treatment program is ineffective or unsafe. We do not recommend patients seeking treatment with this program.

Additional Physical & Mental Health Support

Eating disorders are unique among mental illnesses because they can severely damage the physical body. Associated health issues include anemia, osteoporosis, constipation, and potentially irreversible damage to the heart and brain. They can also lead to tooth enamel erosion, acid reflux, dehydration, and intestinal distress. Those with binge eating disorders are at higher risk for high blood pressure, heart disease, and diabetes, further complicating their health.

An ideal online eating disorder treatment program should provide physical health support or collaborate with a patient’s clinician/primary care provider (PCP) to ensure comprehensive care. Programs that include these services in the overall cost of recovery score higher, as they offer essential physical health support without additional financial burden. This integrated approach addresses both the mental and physical aspects of eating disorders, promoting a more holistic and effective recovery process.

People with eating disorders often also struggle with other mental illnesses, such as depression, anxiety, or substance use issues. Addressing these co-occurring conditions is crucial for effective treatment. Programs that offer care for comorbid diagnoses score higher, as this supports a “whole-person” approach to recovery, considering all aspects of a patient’s life, including physical and mental health, lifestyle, and nutrition.

Leaving a co-occurring diagnosis untreated can significantly reduce the likelihood of success in an eating disorder treatment program. Ideal services should include a comprehensive evaluation, a personalized treatment plan, and a structured appointment schedule to monitor progress. Additionally, relevant prescriptions should be easily accessible, ensuring access to necessary medications.

Star Ratings for Additional Physical & Mental Health Support

5-stars – The company has successfully met all the standards of an effective online treatment program by addressing both eating disorders and co-occurring physical ailments, mental illnesses, and mood disorders. By providing care for comorbid diagnoses (or working closely with the patient’s clinician/PCP), they adopt a “whole-person” approach to recovery, ensuring that all aspects of a patient’s life are considered and addressed in the treatment process.

Their services include comprehensive evaluations to accurately diagnose all conditions, personalized treatment plans tailored to each patient’s unique needs, and a structured appointment schedule to monitor progress. They also ensure that relevant prescriptions are available for delivery or pick-up at local pharmacies, guaranteeing seamless access to necessary medications and supporting a smooth recovery journey.

3-stars – Additional physical and mental health support services are available, but treatment and medication are limited to the most common co-occurring issues and disorders, such as depression, anxiety, and insomnia. The treatment plans lack personalization and structure.

1-star – The company does not offer additional physical and mental health support services.

Additional Support & Resources

Online eating disorder programs will score higher on our scale if they offer additional resources and mental health support for current patients, alumni patients, families, and caregivers. These resources should be scientifically proven to assist effectively in recovery and align with the whole-person approach to treating eating disorders.

Examples of additional support include:

Group Therapy: In addition to individual therapy, group therapy provides a sense of community and shared experience, which can be incredibly valuable for patients.
Meal Support: Guidance and support during meals can help patients establish healthier eating patterns and reduce anxiety related to food.
Family Therapy: Involving family members in therapy sessions helps address familial dynamics that may contribute to the eating disorder and supports a more cohesive recovery process.
Additional Family/Caregiver Support: Resources and counseling for family members and caregivers can empower them to better support their loved one’s recovery.
Meetings and Check-ins for Alumni Patients: Regular follow-up meetings and check-ins for alumni patients ensure ongoing support and help prevent relapse by maintaining connections and accountability.

These resources, which should be included in the cost of the program, enhance the overall effectiveness of the treatment program by addressing the various facets of the patient’s life that impact recovery, promoting a more comprehensive and enduring healing process.

Star Ratings for Additional Resources

5-stars – This company provides comprehensive physical and mental health support. They offer a wide range of scientifically proven resources to aid in recovery, aligning with the whole-person approach to treating eating disorders. Their services include individual and group therapy sessions, meal support, alumni support, and family therapy. All these resources are included in the cost of the program, enhancing its overall effectiveness by addressing the various facets of the patient’s life that impact recovery, and promoting a more comprehensive and enduring healing process.

3-stars – The company provides one or two additional resources or systems of support, but they lack scientific support, substance, and effectiveness.

1-star – The company does not provide additional resources or support beyond a base of therapeutic services.

Geographic Location

When reviewing online eating disorder treatment programs, one of the factors we assess is how widely services are available across the United States. Programs that are more widely available will score higher in this category, as they serve a larger percentage of the population and increase access to care. Programs that are more widely available also make it easier to maintain care during a move, travel, or when frequently commuting between states for work or school.

Star Ratings for Geographic Location

5-stars – Treatment is available nationwide OR covers 50% or more of the US population.

3-stars – Treatment covers around 30% of the US population.

1-star – Treatment covers less than 10% of the US population.

Cost of Care

The best online eating disorder treatment programs will be clear and upfront about the expected costs for services. Patients should know all expected costs prior to signing up for services.

It should also be easy to understand how you’ll be charged, either through your credit card or FSA/HSA card and when charges will occur. There should be no hidden costs for extra features, like nutritional support, group sessions, or meal planning. The best online treatment programs will also offer sliding scale fees, discounts, or payment plans of some type to make services more accessible.

Star Ratings for Cost of Care

5-stars – Total cost of care and services are clearly provided prior to signing up and there are no additional hidden fees. There are sliding scales or discounts available to those who qualify.

3-stars – Total cost of care isn’t initially clear, but there are no additional hidden costs. If there are sliding scales or discounts available, you have to ask about this prior to signing up.

1-star – Total cost of care is not provided until after you have completed the registration process. Billing practices are inconsistent and confusing. There are no discounts, sliding scales, or payment plans available to make treatment more accessible.

Insurance & Out-of-Network Benefits

Whether an online eating disorder treatment program accepts insurance will be a deciding factor for many seeking treatment. In addition to accepting insurance, we also look at how many insurance plans are accepted and whether they’re specific to certain states. Ideal programs will have an enrollment coordinator who assists all patients with this process before they see a provider.

Additionally, we look at whether a program assists patients in using out-of-network benefits. Companies that provide a more “white glove” service when it comes to paying with insurance or using out-of-network benefits, and that make the process as easy and understandable as possible, will earn more points in this category.

Star Ratings for Insurance & Out-of-Network Benefits

5-stars – The company accepts insurance from many major insurance providers. The process of inputting insurance information is easy and there is a live person available if patients need help with this process. The patient’s insurance is run before they begin the program and they know whether their insurance covers the service and what the out-of-pocket costs will be well in advance. OR If insurance is not accepted, the program accepts HSA or FSA funds to pay for the cost of treatment or will create and submit a superbill to bill out-of-network benefits on the client’s behalf to their insurance company.

3-stars – The company accepts select major insurance providers or select insurance plans by state. The process for inputting your insurance is easy, but there is not a live person available to help you with the process. Insurance may be run prior to an appointment or afterward and out-of-pocket costs can come as a surprise. The program will accept either HSA or FSA funds to pay for treatment, OR they will create and submit a superbill for patients, but they will not allow both.

1-star – The company does not accept insurance at all. The program does not accept HSA funds or FSA cards to pay for treatment. They offer a superbill, but patients must submit it to their insurance company themselves to bill their out-of-network benefits.

Reliability & Longevity

The reliability and longevity score of an online eating disorder treatment program will be determined by several key factors.

These key factors include:

Duration of Operation: The length of time the treatment program has been operational provides insight into its stability and track record of success.
Provider Network and Coverage: The number of providers within the program and the number of states they serve indicate the program’s accessibility and capacity to meet diverse patient needs.
Insurance Acceptance: The range of top insurance providers accepted by the program reflects its financial accessibility and integration into the broader healthcare system.
Company Growth: The amount of growth the company has experienced over the past three years showcases its ability to expand and adapt, which is critical for long-term viability.
Patient Reviews: Patient reviews on the quality of care offer valuable insights into the real-world effectiveness and patient satisfaction with the program.

Our goal is to guide users toward online programs that are not only effective but also stable and likely to continue growing, ensuring they won’t disappear or phase out after a patient signs up for treatment. It’s important to note that we regularly update our online eating disorder treatment program reviews. This means that a newer program may receive a higher score in the future once it has proven its reliability and longevity over time, reflecting our commitment to providing current and accurate assessments.

Star Ratings of Reliability & Longevity

5-stars – The company has been in operation for more than five years and serves 50% of the US population. The program works with the top insurance companies in the states they provide care. The program has grown over the past three years and user reviews express very few complaints about the service. They are consistently meeting or exceeding the patient’s needs and expectations.

3-stars – The company has been in operation for three years and can serve 30% of the US population. There are only a few major insurance companies the program accepts and they have been working with them for less than three years. The program is still growing and user reviews mention some complaints about the service. Patients’ needs and expectations are sometimes met.

1-star – The company is brand new and has been active for one year and serves 10% of the US population. They do not work with any insurance companies and complaints or compliments are hard to find, as there are few user reviews available.

Care Team Credentials & Expertise

When a patient signs up for an online eating disorder treatment program, several professionals should be included on their care team.

For instance, an ideal company should provide:

Licensed counselors or therapists with strong backgrounds in eating disorder recovery
Licensed clinicians and prescribers with substantial experience in eating disorder recovery
Supplemental support staff, such as care coordinators and nutritionists
Enrollment coordinators who are proficient in medical billing, insurance, and onboarding

We also examine each company’s hiring processes to see the quality standards they have in place, what levels of education and experience they expect from staff, and if these qualifications are clear to patients before registration. Companies that are not transparent about their hiring practices, offer incomplete care teams or do not list licenses or certifications of their staff members will score lower in this category.

Star Ratings for Care Team Credentials & Expertise

5-stars – Patients are provided with a complete care team upon registration. Each professional holds a strong background in their area of expertise. The company’s hiring process is transparent, licenses and certifications of healthcare providers are clearly listed, and the quality of care is held to a high standard.

3-stars – Patients are provided with a care team, but the background and expertise of the members are not clear. The company does not list certifications or licenses of their healthcare providers and does not share hiring practices, but will provide this information upon request.

1-star – Patients are not provided with a consistent care team. They see different support staff for every appointment and the company refuses to provide information on their care team’s credentials and expertise.

Customer Service

As with any healthcare program, the quality of customer service is a significant rating factor. A company may be penalized in this category if it’s difficult to find customer support contact information or connect with a representative, or if it lacks channels of communication to contact support (e.g., only has email, no phone numbers listed).

We also take into consideration user reviews from trusted sources when scoring for customer service. We research and analyze positive and negative reviews that mention customer service and track when the company responds to complaints on trusted user review websites, as well as in the Apple App Store and Google Play Store when relevant. Companies that provide prompt and effective feedback and support will score higher in this category.

Star Ratings for Customer Service

5-stars – The company offers excellent customer service. There are multiple channels to communicate with a representative, including email, text, chat, and phone. Responses to issues and complaints are completed within two business days. There are very few, if any, customer complaints in reviews online. When problems are reported in reviews online, the company responds efficiently and effectively.

3-stars – The company provides an average level of customer service. There are limited channels to communicate with a representative. Response time takes more than 3 business days. The company will sometimes respond to issues reported in reviews online.

1-star – The company provides poor customer service. You can only reach a representative through one channel. Response time takes over a week and many issues are left unresolved. The company does not respond to reported issues in reviews online.

Privacy & HIPAA

Digital privacy, confidentiality, and HIPAA compliance are important to consider when choosing an online eating disorder recovery program. An ideal program keeps the client’s account information, such as credit card numbers, email addresses, diagnosis, or other identifying data, private and protected by legal standards at all times. When ranking for this category, our objective is to promote companies that have transparent and ethical privacy and HIPAA policies, as well as data-sharing practices, and who consistently meet clients’ privacy and HIPAA expectations. Companies that are unclear about these policies and/or exhibit unethical actions regarding privacy, security, data sharing, or HIPAA will receive lower scores.

Star Ratings for Privacy & HIPAA

5-stars – Privacy and HIPAA policies are easy to find, clearly stated, and specific. The company is transparent about data-sharing practices and consistently meets clients’ expectations. There are no reports of security issues, such as personal information or credit card information being stolen or client information being sold to third parties. Patients are prompted to sign a HIPAA agreement acknowledging they are on a HIPAA-compliant platform during the sign-up process, and all HIPAA policies are adhered to.

3-stars – Privacy and HIPAA policies, as well as data sharing practices, are difficult to find and/or generic and unspecific OR there have been some incidents of users facing security issues with private information. Patients are prompted to sign a HIPAA agreement only prior to their registration into the program, but it was not made clear during the sign-up process the platform uses HIPAA-compliant software.

1-star – The company has no stated privacy policy. There have been many reports of security issues with private user information. The company shares member account information without informing the user. Patients are never asked to sign a HIPAA agreement and it is unclear if the company is actually using HIPAA-compliant software.

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This content was last updated 07/15/2024 by the Choosing Therapy team.