Eating disorder treatment is a long-term process involving a potentially life-threatening situation. Treatment is extremely expensive with therapy most likely extending well over two years. Most eating disorder treatment takes place on an outpatient basis. Outpatient therapy refers to individual, family, or group therapy sessions taking place in a therapist's or other professional's office and is usually conducted one to three times per week. Individual sessions generally run forty-five minutes to an hour, and family or group sessions are usually sixty to ninety minutes. Sessions can be arranged for more or less time if needed and as deemed appropriate by the treating professional. The cost of outpatient treatment, including therapy, nutritional counseling, and medical monitoring, can extend to $100,000 or more.

There may come a time when outpatient treatment is insufficient or contraindicated due to the severity of the eating disorder. Treatment in a more intense structured setting, such as a hospital or residential facility, may be required when symptoms are out of control and/or the medical risks are significant. If treatment necessitates a round-the-clock or more acute program, such as an inpatient hospital stay, this alone can be $30,000 or more per month with some patients needing several months or repeated hospitalizations.

Most people consider a treatment program as a last resort; however, if specifically designed for eating disorders, this kind of program can be an excellent option even in the beginning of treatment. There are a variety of settings that provide more intense levels of care than outpatient therapy. When looking for a treatment program it is important to understand the difference between the intensity and structure of different levels of care. The various options include inpatient, partial hospitalization or day treatment programs, residential treatment facilities, and halfway or recovery houses. These options will be described below.

TREATMENT PROGRAM OPTIONS

Inpatient treatment means twenty-four-hour care in a hospital setting, which can be a medical or psychiatric facility or both. The cost is usually quite high, around $1,200 to $1,400 per day. Inpatient treatment at a strictly medical hospital is usually a short-term stay to treat medical conditions or complications that have arisen as a result of the eating disorder. In some cases, a patient may stay longer simply because her medical condition is severe. In other cases, patients stay longer in a medical hospital than is medically necessary because there is no other facility close by to treat the patient. This is particularly true if the hospital has provisions or a treatment protocol for eating disorders. The rest of the inpatient treatment of eating disorders takes place in psychiatric hospitals that utilize nearby or associated medical facilities when necessary. It is very important that these psychiatric hospitals have trained eating disorder professionals and a treatment program or special protocol for treating eating disorders. Treatment in a hospital without specialized care for eating disorders will not only be unsuccessful but can cause more harm than good.

Often individuals need a more structured program than outpatient treatment but do not need twenty-four-hour care. Additionally patients who have been in an inpatient program can often step down to a lower level of care but are not ready to return home and begin outpatient treatment. In these cases partial programs or day treatment programs may be indicated. Partial programs come in a variety of forms. Some hospitals offer programs a few days per week, or in the evening, or a few hours each day. Day treatment generally means the person is in the hospital program during the day and returns home in the evening. These programs are becoming more prevalent, in part due to the cost of full inpatient programs and also due to the fact that patients can receive great benefits from these programs without the additional burden or stress of having to leave home entirely. Due to the amount of variation in these programs it is not possible to give a fee range.

The majority of eating disordered individuals are not medically unstable or actively suicidal and do not require hospitalization. How-ever, a substantial benefit may be received if these individuals can have supervision and treatment on a twenty-four-hour-per-day basis of a different nature than hospitalization. Bingeing, self-induced vomiting, laxative abuse, compulsive exercise, and restricted eating do not necessarily lead to acute medical instability and thus do not qualify by themselves as criteria for hospitalization. If this is the case, many insurance companies will not pay for hospitalization since coverage often requires the individual to be dangerously medically compromised. However, eating disorder behaviors can become so habitual or addictive that trying to reduce or extinguish them on an outpatient basis can seem almost impossible. Residential treatment facilities offer an excellent alternative, providing round-the-clock care in a more relaxed, affordable, nonhospital setting.