An eating disorder is a mental health condition that causes disturbances to your diet and the way you view food.
There are several types of eating disorders. Some examples include:
- anorexia nervosa
- bulimia nervosa
- binge eating disorder
People that have an eating disorder may eat too much food, too little food, or become preoccupied with their body shape or weight. Without treatment, an eating disorder may become serious and potentially life-threatening.
However, recovery from an eating disorder is possible with treatment. This often involves a team of health professionals that work together to help you on your way to recovery.
One part of your treatment plan will involve therapy.
Below, we’ll explore the different types of therapy for eating disorders, how effective they are, and ways to seek help for yourself or a loved one.
Options for care
There are many levels of care that are available for the treatment of eating disorders.
Intensive outpatient or outpatient
Outpatient means that you return home following a treatment session. This level of care is often used for individuals who:
- don’t need to be monitored on a daily basis
- are functioning well in school, work, or social settings
- are continuing to make progress in their recovery
Outpatient programs may vary in intensity depending on an individual’s needs. Some may have sessions once or twice per week, while more intensive programs often involve sessions that are longer and more frequent.
You may also see these referred to as “day hospital” programs. They’re more intensive than an outpatient program and may be recommended for someone who:
- needs to be monitored on a daily basis
- has an eating disorder that impacts their ability to function, but not in a manner that poses an immediate risk
- performs activities like bingeing, purging, or fasting on a daily basis
A partial hospitalization program typically involves sessions that can last several hours and occur most days out of the week.
People in a residential treatment program temporarily live in a facility that’s specifically aimed at addressing eating disorders. These facilities offer their residents monitoring and care around the clock.
This type of program is often recommended for people that:
- need longer term care for their eating disorder
- require daily monitoring
- haven’t responded to outpatient or partial hospitalization treatment programs
The length of time that a person spends in a residential program depends on the severity of their condition as well as the individual facility.
This level of care involves a stay at a hospital. It’s used for individuals with an eating disorder who are experiencing a medical emergency, such as:
- unstable vital signs
- symptoms that have worsened quickly
- complications due to their eating disorder or another underlying health condition
- suicidal ideation
Hospitalization aims to stabilize your condition. When you’re discharged, an outpatient, partial hospitalization, or residential program will be recommended based off your individual situation.
Types of therapy
Various types of therapy can be used in the treatment of eating disorders. Below, we’ll explore each type of therapy in more detail.
Cognitive behavioral therapy (CBT) and enhanced cognitive behavioral therapy (CBT-E)
CBT aims to identify the thought patterns and beliefs that contribute to your eating disorder.
These could include thoughts or beliefs that are associated with things such as:
- body shape
Once these thoughts and beliefs are identified, you’re then taught strategies to modify them and to help manage them.
CBT is used for a variety of mental health conditions, and people receiving CBT for eating disorders experience improvements in other related symptoms like depression and anxiety.
CBT-E (enhanced) is a type of CBT that’s intended for use in all types of eating disorders.
Interpersonal psychotherapy (IPT)
IPT is a type of therapy that’s used to treat eating disorders like binge eating disorder or bulimia. In IPT, your eating disorder is explored in the context of social and interpersonal relationships.
Four different “problem areas” are used in IPT. These include:
- Interpersonal deficits: This often includes feelings of isolation or a lack of close, fulfilling relationships. The relationships in question don’t have to be romantic, but can also be related to those with friends or family.
- Role disputes: This often involves a difference in expectations between yourself and one or more important people in your life, such as parents, friends, or employers.
- Role transitions: This is typically concerned with big life changes, such as being on your own for the first time, starting a new job, or being in a new relationship.
- Grief: This can include feelings of loss due to the death of a loved one or the end of a relationship.
Your doctor will work with you to explore how issues in each of these problem areas contribute to your eating disorder. They’ll then help you develop strategies to improve your communication and interpersonal skills to help reduce your symptoms.
Family-based treatment (FBT)
You may also see this type of therapy referred to as the Maudsley Method. It’s often used for children or adolescents that have an eating disorder.
In FBT, your family members are vital parts of your recovery process. They’re involved in helping you do things like:
- maintaining healthy eating patterns
- restoring and maintaining a healthy weight
- interrupting unhealthy behaviors, such as binge eating or purging
Dialectal behavior therapy (DBT)
DBT focuses on managing difficult emotions. With DBT, you’ll learn skills to change the behaviors associated with your eating disorder.
Some specific skills that DBT aims to build include:
- interpersonal skills
- emotional expression
- flexibility and openness
- coping with feelings of distress
- encouraging mindfulness
DBT has been studied in the treatment of binge eating disorder, anorexia nervosa, and bulimia nervosa.
Acceptance and commitment therapy (ACT)
ACT asks you to focus on changing your actions as opposed to your thoughts or feelings.
A principle of ACT is that the behaviors associated with mental health conditions come from responses to unpleasant feelings like anxiety or pain.
People undergoing ACT are asked to examine for themselves what their core values are. They’re then asked to develop goals that help them better satisfy these values.
The aim is to accept all feelings — including the unpleasant ones — and to commit to changing your actions so they better align with your core values. Through this, it’s believed that you can lead a better life and begin to feel better.
ACT is a viable treatment for eating disorders, but more research is needed to see if it’s effective as a standalone therapy.
Cognitive remediation therapy (CRT)
CRT focuses on promoting big-picture thinking and mental flexibility. It’s currently used in the treatment of anorexia nervosa.
In CRT, a variety of exercises and tasks are used to help address the rigid thinking patterns that are often associated with anorexia nervosa. Some examples of such tasks include:
- drawing shapes or performing motions with your dominant and nondominant hand
- asking you to repeatedly switch your attention between two topics
- reading and summarizing increasingly difficult passages
- finding different ways to navigate a map
- asking you to come up with alternative ways to use everyday objects
The overall goal of psychodynamic psychotherapy is to help you understand the underlying cause of your eating disorder. This involves diving deep into things such as your internal conflicts and motives.
Providers of this type of therapy believe that your symptoms are the result of unresolved wants and needs. As such, understanding the root cause of your disorder can address your symptoms and reduce your risk of relapse.
You may be wondering which types of therapy are most effective for the treatment of eating disorders. The answer to this question can depend on the type of eating disorder you have.
Additionally, different types of therapy work best for different individuals. Because of this, you may need to try a few different approaches before you find one that works for you.
What therapies are most effective?
Some types of therapy for eating disorders are more established than others.
- No single therapy method was most effective for adults with anorexia nervosa. However, many people with anorexia do see an improvement with therapy.
- CBT and IPT are the most established treatments for binge eating disorder and bulimia nervosa.
- FBT is the most established type of therapy for children and adolescents with anorexia nervosa, and may also be beneficial for those with bulimia nervosa.
What about other types of therapies?
Researchers continue to investigate the efficacy of other therapies that we discussed above. Below is a snapshot of some of the results:
- ACT: A 2020 study assessed 99 women with residual eating disorder symptoms and body image problems. At a 2-year follow-up, women who had received 12 sessions of ACT had fewer symptoms than those who didn’t receive ACT.
2018 studylooked at using CRT for 145 women with anorexia nervosa in an inpatient program. Results suggested that CRT may be beneficial as a supplemental treatment for anorexia nervosa, but further research is needed.
small 2015 studyassessed DBT for treating anorexia nervosa. It found that specifically targeting skills like flexibility, openness, and interpersonal skills may be helpful in treating this disorder.
- Psychodynamic psychotherapy: A 2016 paper reviewed 47 studies of psychodynamic psychotherapy for treating eating disorders. It noted that while studies are scarce, the available data supports the use of this therapy for eating disorders, particularly for anorexia, but noted that more studies are needed to test its effectiveness.
Recovery versus cure
As we discuss the effectiveness of these therapies, it’s important to be cautious when using the word “cure” in the context of eating disorders. A more accurate term to use is “recovery.”
Therapy for eating disorders aims to equip you with skills and strategies you can implement into your everyday life to address your condition. In this way, you can achieve recovery, during which you experience little to no symptoms.
It’s possible for someone who has recovered from an eating disorder to relapse. This is not uncommon with many eating disorders.
You can help manage a relapse by:
- Acknowledging that the relapse occurred and that this is normal with eating disorders.
- Notifying your care provider and support network of what you’re experiencing.
- Being kind to yourself — you have not failed!
- Identifying actionable steps in your treatment plan to help resume your recovery.
A note about hope
If you believe that you or a loved one has an eating disorder, it’s important to remember that help is always available. Recovery from an eating disorder is possible by seeking treatment.
There are numerous resources available to help you find treatment. In the sections below, we’ll discuss where to find help and how to talk with a doctor.
Where to find help
You can use the resources below to find help that’s available in your area.
Your primary care provider
Your primary care doctor can be an important initial resource for getting help with an eating disorder. They can help evaluate your symptoms and eating patterns, and can refer you to a treatment specialist close to you.
National Eating Disorders Association (NEDA)
NEDA is a nonprofit organization that works to support those that have an eating disorder. Their website contains a wealth of information about eating disorders, treatment, and support.
Additional resources from NEDA that you may find helpful include:
- Treatment locator: This map tool can help you find a treatment provider close to you.
- NEDA helpline: You can use the NEDA helpline (800-931-2237) to find support and treatment resources that are available to you. It’s available Monday through Friday, although you can leave a message after hours.
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
ANAD is a nonprofit organization that aims to help people with eating disorders get care and support.
They have several resources that you can use, such as:
- Treatment directory: The ANAD treatment directory can help you find a treatment provider in your area.
- Helpline: The ANAD helpline (630-577-1330) provides information, offers support, and gives treatment referrals. It’s available Monday through Friday and on Sundays. You can leave a message after hours.
- Support groups: There are several virtual support groups that meet on a regular basis.
National Alliance on Mental Illness (NAMI)
NAMI aims to offer education, support, and public awareness of mental health issues.
Some NAMI resources you may find useful are:
- Helpline: The NAMI helpline (1-800-950-6264) provides information, support, and treatment referrals to those with mental health conditions. It’s available Monday through Friday.
- Support groups: NAMI offers support groups throughout the country for people with mental health conditions and their families.
Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA is a government agency that addresses mental health and substance use concerns throughout the country. Their website has a treatment locator that you can use to find a treatment facility in your area.
Additionally, the SAMHSA National Helpline (1-800-662-4357) is available 24 hours a day, 365 days per year. You can call this number to receive a referral for a treatment facility near you. All information is kept confidential.
How to talk with a doctor
Getting help for an eating disorder may initially seem challenging or scary. These feelings are normal — discussing concerns about our bodies or our mental health can require us to be more vulnerable than we’re used to.
Remember: Seeking help is a big first step on your recovery journey.
If you think you may have an eating disorder, make an appointment with your doctor to discuss your concerns. You can choose to see your primary care doctor or a mental health professional.
Try to be as open as possible with your doctor about your thought patterns, eating habits, and concerns. Also, don’t hesitate to ask questions if you have them.
If you’re nervous, it may be helpful to bring a family member or friend along with you for support.
If you’re concerned about a loved one
A friend or family member that has an eating disorder may not believe they need to seek treatment. They may also be defensive about topics like their diet and weight.
If you’re worried that someone close to you has an eating disorder, speak with them openly and compassionately about your concerns.
Encourage them to seek treatment. If they’re scared or unsure, offering to go with them may be helpful.
The bottom line
Treating an eating disorder often involves some form of therapy. The specific therapy method that’s used can depend on the eating disorder you have, as well as which approach is most effective for you personally.
Overall, therapy helps you learn strategies that can help change the thought patterns or behaviors associated with your eating disorder. By using these in your daily life, you can reach recovery.
If you have an eating disorder, it’s always important to know that help is available and that there are many resources that can aid you in finding help.
Remember that seeking care is an important initial step in your recovery journey.