Treatments for eating disorders include therapy, education and medication. Find out what works.By Mayo Clinic Staff
Eating disorder treatment depends on your particular disorder and your symptoms. It typically includes a combination of psychological therapy (psychotherapy), nutrition education, medical monitoring and sometimes medications.
Eating disorder treatment also involves addressing other health problems caused by an eating disorder, which can be serious or even life-threatening if they go untreated for too long. If an eating disorder doesn't improve with standard treatment or causes health problems, you may need hospitalization or another type of inpatient program.
Having an organized approach to eating disorder treatment can help you manage symptoms, return to a healthy weight, and maintain your physical and mental health.
Whether you start by seeing your primary care practitioner or some type of mental health professional, you'll likely benefit from a referral to a team of professionals who specialize in eating disorder treatment. Members of your treatment team may include:
- A mental health professional, such as a psychologist to provide psychological therapy. If you need medication prescription and management, you may see a psychiatrist. Some psychiatrists also provide psychological therapy.
- A registered dietitian to provide education on nutrition and meal planning.
- Medical or dental specialists to treat health or dental problems that result from your eating disorder.
- Your partner, parents or other family members. For young people still living at home, parents should be actively involved in treatment and may supervise meals.
It's best if everyone involved in your treatment communicates about your progress so that adjustments can be made to treatment as needed.
Managing an eating disorder can be a long-term challenge. You may need to continue to see members of your treatment team on a regular basis, even if your eating disorder and related health problems are under control.
You and your treatment team determine what your needs are and come up with goals and guidelines. Your treatment team works with you to:
- Develop a treatment plan. This includes a plan for treating your eating disorder and setting treatment goals. It also makes it clear what to do if you're not able to stick with your plan.
- Treat physical complications. Your treatment team monitors and addresses any health and medical issues that are a result of your eating disorder.
- Identify resources. Your treatment team can help you discover what resources are available in your area to help you meet your goals.
- Work to identify affordable treatment options. Hospitalization and outpatient programs for treating eating disorders can be expensive, and insurance may not cover all the costs of your care. Talk with your treatment team about financial issues and any concerns — don't avoid treatment because of the potential cost.
Psychological therapy is the most important component of eating disorder treatment. It involves seeing a psychologist or another mental health professional on a regular basis.
Therapy may last from a few months to years. It can help you to:
- Normalize your eating patterns and achieve a healthy weight
- Exchange unhealthy habits for healthy ones
- Learn how to monitor your eating and your moods
- Develop problem-solving skills
- Explore healthy ways to cope with stressful situations
- Improve your relationships
- Improve your mood
Treatment may involve a combination of different types of therapy, such as:
- Cognitive behavioral therapy. This type of psychotherapy focuses on behaviors, thoughts and feelings related to your eating disorder. After helping you gain healthy eating behaviors, it helps you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
- Family-based therapy. During this therapy, family members learn to help you restore healthy eating patterns and achieve a healthy weight until you can do it on your own. This type of therapy can be especially useful for parents learning how to help a teen with an eating disorder.
- Group cognitive behavioral therapy. This type of therapy involves meeting with a psychologist or other mental health professional along with others who are diagnosed with an eating disorder. It can help you address thoughts, feelings and behaviors related to your eating disorder, learn skills to manage symptoms, and regain healthy eating patterns.
Your psychologist or other mental health professional may ask you to do homework, such as keep a food journal to review in therapy sessions and identify triggers that cause you to binge, purge or do other unhealthy eating behaviors.
Registered dietitians and other professionals involved in your treatment can help you better understand your eating disorder and help you develop a plan to achieve and maintain healthy eating habits. Goals of nutrition education may be to:
- Work toward a healthy weight
- Understand how nutrition affects your body, including recognizing how your eating disorder causes nutrition issues and physical problems
- Practice meal planning
- Establish regular eating patterns — generally, three meals a day with regular snacks
- Take steps to avoid dieting or bingeing
- Correct health problems that are a result of malnutrition or obesity
Medications can't cure an eating disorder. They're most effective when combined with psychological therapy.
Antidepressants are the most common medications used to treat eating disorders that involve binge-eating or purging behaviors, but depending on the situation, other medications are sometimes prescribed.
Taking an antidepressant may be especially helpful if you have bulimia or binge-eating disorder. Antidepressants can also help reduce symptoms of depression or anxiety, which frequently occur along with eating disorders.
You may also need to take medications for physical health problems caused by your eating disorder.
Hospitalization may be necessary if you have serious physical or mental health problems or if you have anorexia and are unable to eat or gain weight. Severe or life-threatening physical health problems that occur with anorexia can be a medical emergency.
In many cases, the most important goal of hospitalization is to stabilize acute medical symptoms through beginning the process of normalizing eating and weight. The majority of eating and weight restoration takes place in the outpatient setting.
Day treatment programs are structured and generally require attendance for multiple hours a day, several days a week. Day treatment can include medical care; group, individual and family therapy; structured eating sessions; and nutrition education.
With residential treatment, you temporarily live at an eating disorder treatment facility. A residential treatment program may be necessary if you need long-term care for your eating disorder or you've been in the hospital a number of times but your mental or physical health hasn't improved.
Eating disorders can cause serious health problems related to inadequate nutrition, overeating, bingeing and other factors. The type of health problems caused by eating disorders depends on the type and severity of the eating disorder. In many cases, problems caused by an eating disorder require ongoing treatment and monitoring.
Health problems linked to eating disorders may include:
- Electrolyte imbalances, which can interfere with the functioning of your muscles, heart and nerves
- Heart problems and high blood pressure
- Digestive problems
- Nutrient deficiencies
- Dental cavities and erosion of the surface of your teeth from frequent vomiting (bulimia)
- Low bone density (osteoporosis) as a result of irregular or absent menstruation or long-term malnutrition (anorexia)
- Stunted growth caused by poor nutrition (anorexia)
- Mental health conditions such as depression, anxiety, obsessive-compulsive disorder or substance abuse
- Lack of menstruation and problems with infertility and pregnancy
You are the most important member of your treatment team. For successful treatment, you need to be actively involved in your treatment and so do your family members and other loved ones. Your treatment team can provide education and tell you where to find more information and support.
There's a lot of misinformation about eating disorders on the web, so follow your treatment team's advice and get suggestions on reputable websites to learn more about your eating disorder. Examples of helpful websites include the National Eating Disorders Association (NEDA), as well as Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.).
July 14, 2017
- Eating disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml?utm_source=rss&utm_medium=rss. Accessed May 22, 2017.
- Forman SF. Eating disorders: Overview of treatment. https://www.uptodate.com/home. Accessed May 22, 2017.
- Eating disorders: About more than food. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml. Accessed May 22, 2017.
- Eating disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Eating-Disorders/Overview. Accessed May 22, 2017.
- What are eating disorders? American Psychiatric Association. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders. Accessed May 22, 2017.
- Practice paper of the American Dietetic Association: Nutrition intervention in the treatment of eating disorders. Journal of the American Dietetic Association. 2011:111:1236.
- Gabbard GO, ed. Evidence-based psychological treatments for eating disorders. In: Gabbard's Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; 2014. http://psychiatryonline.org/doi/book/10.1176/appi.books.9781585625048. Accessed May 22, 2017.
- Gabbard GO, ed. Pharmacological treatment of eating disorders. In: Gabbard's Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; 2014. http://psychiatryonline.org/doi/book/10.1176/appi.books.9781585625048. Accessed May 22, 2017.
- Gabbard GO, ed. Intensive treatment for eating disorders. In: Gabbard's Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; 2014. http://psychiatryonline.org/doi/book/10.1176/appi.books.9781585625048. Accessed May 22, 2017.
- Eating disorders. American Psychological Association. http://www.apa.org/helpcenter/eating.aspx. Accessed May 22, 2017.
- Sim LA (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.