What to Expect from Eating Disorder Treatment: A Thorough Description of the Process and Practical Tips
Written by ‘Ai Pono Hawaii Staff Writer
If you are reading this, you are considering or about to enter eating disorder treatment. If you’re still contemplating, that’s okay too. It’s normal to wonder whether you “need” treatment, whether you can afford it, whether it’s feasible in your life right now, or other things.
In the contemplation stage, you might only see barriers. But it’s important to remember that the real barrier in your life is your eating disorder. Your disorder knows that, which is why it is the one throwing up barriers to keep you trapped. Admitting to yourself that you need help is a huge first step. Looking for and receiving that help can be scary.
The treatment process is one full of change, of unknowns, but you don’t have to go into treatment blind. Here, we answer in-depth the question, “What is eating disorder treatment like?” You’ll learn:
How to prepare for your first day of treatment
What to expect on your first day of treatment
The day-to-day rules and routines of treatment
Post-treatment relapse prevention
You’ll also learn some practical tips for managing each stage of treatment.
Related: Not sure how to pay for eating disorder treatment? Click here for help.
Getting Ready for Treatment
There are three “higher levels of care” when it comes to eating disorder treatment including: Intensive Outpatient Program (IOP), Partial Hospitalization Program (PHP), and Residential care.
Related: Read more about each level of care here.
Before starting treatment, you will be asked to complete both physical and mental assessments to help determine the appropriate level of care. If you are medically compromised, or at risk of suicide, you will need around-the-clock supervision.
Practical Tips to Prepare for Your First Day of Treatment (At Any Level)
No matter what level of care you are entering, there are key things you can do to make that first day (and every day in treatment) easier:
Consider wearing loose fitting, comfortable clothing. You will probably feel uncomfortable and self-conscious in your body, especially if comparing it to others.
Bring along some activities/self-soothing tools. Many people bring things like coloring books, books to read, journals, or fidget toys. You will have downtime in between groups and may want to use distractions to get through challenging meals.
Bring pictures that make you smile. Pictures of family, friends, and pets may motivate you or help you feel less alone.
Write down a list of reasons you want to recover. Carry the list around with you for motivation.
Call ahead/come prepared with any questions you may have about the treatment process.
Note: If you are entering residential treatment. you will be given a list of what you can and cannot bring. Staff will inspect your belongings and check for potentially dangerous items before they are returned to you.
What Happens During Treatment
You might be overwhelmed during treatment. It’s normal. From being in a new environment with new rules, to meeting so many new people, to challenging meals and therapies, it’s just a lot. Don’t be too hard on yourself if you hit roadblocks or can’t meet a challenge.
Remember: Recovery is not linear.
Your First Day in Treatment (At Any Level)
No matter what level of care you are entering, your first day will be filled with paperwork, meeting your treatment team, and setting up a treatment plan.
Treatment teams are usually composed of an individual therapist, dietician, and psychiatrist (if needed). Treatment plans involve identifying eating disorder behaviors and making plans to mitigate them, prescribing a meal plan, and discussing any other treatment goals you may have.
Be honest with your treatment team. This is important to do throughout the whole of your treatment experience. Lying to your team is essentially giving them misinformation, and then they can’t give you an effective treatment plan.
You will be given a tour of the treatment center, and a copy of your program’s schedule.
The Everyday Rules and Routines of Treatment
The rules and routines in treatment are there to help you break your eating disorder habits. They are not made to be unfair or terrible, even if they may feel like it at times.
You will be expected to be in the kitchen/dining room for every meal and snack you have in-program. The number of group meals and snacks you have will vary depending on your level of care. There are support staff at every meal/snack to help guide you through them. They also estimate how much of your meal/snack you completed. In most programs, if you do not complete enough of your meal/snack, you may be provided with a meal supplement. If the food itself is too challenging, then supplements help you take in needed nutrition.
After meals and snacks, the bathrooms on-site will be locked for and hour or so that no one can act on eating disorder urges or behaviors. If you must go, someone will listen as you are in the bathroom, just to make sure you aren’t attempting to act on urges.
You will be expected to participate in groups. Many treatment centers will collect patient phones during groups to encourage participation (and out of respect for the group leader). In Residential treatment, there may be designated phone times, or some programs may ask that you surrender your phone and technology completely in order to fully engage in the treatment process.
You will be weighed. This process will vary depending on your level of care. PHP programs usually take place in the morning. 3-4 times a week, you are weighed before breakfast. In IOP, you are usually weighed 1-2 times a week, before the first scheduled meal/snack in-program. In residential/inpatient, you will be given a time you have to wake up to have your weight and vital signs taken.
You may or may not be able to see or know your weight. This also depends on your level of care. There are many pros and cons of blind weighing. You can discuss with your team whether knowing your weight is helpful or harmful.
You may be given a “food log” to record what you eat and drink. There is space on the log to record how much of your meal plan you meet every day, and thoughts/emotions that arise for you throughout the meal/snack. You will then review it with your therapist and/or dietician.
You will “challenge” food fears and rules throughout every level of treatment. This process is known as exposure therapy.
Your treatment team will monitor your progress, and determine when you are able to transition to a lower level of care. They make their decisions based on meal plan completion, how often you engage in behaviors, medical factors, and readiness for leaving a level of care.
Practical Tips for Managing Treatment
If you believe knowing your weight is harmful, then make a plan to not look at it. In treatment settings do not do blind weights, you can ask staff to cover up the number when you’re being weighed. You can step onto the scale backwards. You can close your eyes and think about how little the number actually means.
As your body and body image are changing, it may help to wear loose, comfy clothing. You won’t have to stare at your body parts, or feel fitted clothes on your body.
Change your clothes daily, if you can. If you don’t change, it might start to feel like the days are blurring together.
Keep good hygiene. In the treatment setting, patients sit pretty close to one another. It will also make you feel more fresh every day.
Write down all your recovery wins to build momentum.
Bring a nice journal to treatment. Write down anything you want: notes about groups, a thought dump, thought restructuring, or to calm your emotions.
Do creative things in treatment. Make use of creative materials in your downtime to practice making imperfect things, to make for joy and nothing else.
Do not engage in triggering conversation. Remain focused on your own journey.
Many topics can be triggering for other patients: number of previous admissions, previous levels of care, weight, medical conditions. Try to avoid these triggering topics.
If you have triggered someone, don’t panic. Apologize for doing so, and move on from the subject.
Build your toolkit of coping skills in treatment. Have it at the ready for meals and snacks.
What happens after you leave a treatment program?
Before lowering your level of care, your treatment team will prepare you for managing meals and eating disorder urges on your own.
Before leaving residential, you will want to find a partial program to transition to. From there you would ideally move to IOP. Before leaving IOP, you must coordinate an outpatient treatment team to support you. This includes a therapist, dietician, and psychiatrist (if needed).
Your treatment team will help you make a relapse prevention plan. In it, you identify your triggers, and coping skills to handle them. You will determine the level of severity of triggers, and what to do in high-risk situations. It also includes the names and contact information of your support system, including your treatment team. You’ll write down your recovery goals and how to go about reaching them.
For a model relapse prevention plan, click here.
Remember: You are not alone in this.
It might feel lonely to go into treatment. But you are not alone in the treatment process and you will quickly realize this once you acclimate to your treatment environment, team, and peers.
Leaving treatment may also feel lonely. You become so close with staff and fellow patients in the program, and then have to leave them. It’s hard. But your support system is out there. And you can continue to build it with those in the recovery community.
If you or someone you love is suffering from an eating disorder, take the first step today and talk to talk to someone about recovery or simply learn more about the eating disorder recovery programs we offer.