A Guide to Eating Disorder Recovery: Treatment Levels and Programs
April 25, 2025 | By Carissa Hannum
Originally posted in 2023. This version has been updated with the APA Fourth Edition Practice Guideline for the Treatment of Patients With Eating Disorders.
Being diagnosed with an eating disorder—or realizing that you're experiencing symptoms—can feel overwhelming. Whether it’s anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), or a combination of these, you might find yourself asking, “What do I do?” or “Where should I go for treatment?”
You may start researching your options, only to discover that there are many different types of eating disorder treatment settings, which can be confusing. This blog is here to help guide you through the levels of care available for eating disorder treatment so you can make the best choice for your needs.
Understanding the Levels of Care for Eating Disorders
Just like eating disorder symptoms range in severity, treatment options also exist on a continuum. These are known as Levels of Care (LOC). A person can enter treatment at any level depending on their symptoms and medical/psychiatric needs, typically determined after an initial assessment.
The beauty of this system is its flexibility: individuals can “step up” or “step down” between levels based on how much support they need. As clients gain autonomy and stabilize, they may move to lower levels of care. Conversely, if symptoms worsen or more support is needed, stepping up to a higher level is also an option.
Generally, all levels of care involve a multidisciplinary team who are there to provide personalized care tailored to their needs. The intensity and frequency of treatment teams services vary by level depending on individual goals and medical stability. A team should consist of licensed professionals, which may include the follow:
Therapists (e.g., LPC, LCSW, LMFT, PsyD, PhD) – Licensed mental health providers who offer individual, group, or family therapy.
Registered Dietitians or Nutritionists (e.g., RD, RDN, LDN) – Experts in nutrition who develop meal plans and promote healthy, sustainable eating habits.
Psychiatrists (e.g., MD, DO) – Medical doctors specializing in mental health who can prescribe medication and provide psychiatric evaluations.
Psychiatric Nurse Practitioners and Physician Assistants (e.g., PMHNP, DNP, PA) – Providers qualified to assess mental health needs, prescribe medications, and manage ongoing care.
Medical Doctors – General practitioners or specialists (e.g., pediatricians, internists) who monitor medical status and ensure overall physical health during recovery.
Please note that this list is not exhaustive and credential abbreviations will vary by state and other disciplines.
What Determines the Right Level of Care?
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Clinical Guidelines and Assessment Tools
The American Psychiatric Association (APA) Fourth Edition (2023) of the Practice Guideline for the Treatment of Patients With Eating Disorders provides updated recommendations for evaluating and treating eating disorders.
Importantly, the APA encourages routine screening for eating disorders during initial psychiatric evaluations. This promotes earlier identification and intervention, improving outcomes over time.
Common Criteria to Determine Level of Care
Medical Status: Indicators include abnormal labs, heart rate, vital signs, and need for rehydration or medical stabilization.
Weight and Weight Suppression: Both current weight and recent weight changes are considered.
Motivation for Recovery: Motivation may fluctuate. The guideline recognizes that willingness can grow with support, particularly in higher levels of care.
Suicidality and Self-Harm: The presence and frequency of these behaviors help determine the level of supervision needed.
Co-occurring Mental Health Disorders: This includes anxiety, depression, PTSD, bipolar disorder, and substance use disorders. Addressing these is essential for full recovery.
Compulsive Exercise or Purging Behaviors: Higher levels of care offer structured environments to reduce these behaviors.
Cultural and Individual Considerations: The 4th Edition emphasizes the importance of culturally responsive care, ensuring that treatment respects a client’s identity, background, and values.
Family Involvement: Particularly for adolescents, family-based therapy (FBT) is strongly recommended. Families play a vital role in recovery.
What Are the Levels of Care for Eating Disorder Treatment Programs
Eating disorder recovery is not one-size-fits-all. Treatment is offered at different levels of care depending on a person’s physical health, psychiatric stability, and daily functioning. Below is a breakdown of specialty eating disorder treatment programs and when each may be appropriate.
Outpatient Care for Eating Disorder
Outpatient eating disorder treatment is often a starting point for recovery or a step-down from more intensive care like PHP or residential treatment. It’s ideal for individuals who can manage daily life while continuing to receive therapeutic support.
Outpatient care may be appropriate for individuals who:
Are medically stable and do not require daily medical supervision.
Are psychiatrically stable and can use skills learned in therapy in real-life environments like work, school, and relationships.
Benefit from flexible, consistent support from a multidisciplinary care team while maintaining independence.
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Outpatient Treatment Goals May Include:
Developing a relapse prevention plan for long-term recovery
Building and maintaining a structured meal plan with guidance from a registered dietitian
Identifying and working through fear foods and food-related anxieties
Addressing co-occurring conditions such as anxiety, depression, or trauma
Reducing body image distress and body checking behaviors
Practicing emotional regulation and strengthening coping strategies
Ensuring continued medical stability through regular monitoring
Intensive Outpatient Programs (IOP) for Eating Disorders
IOP programs are designed for individuals who are medically and psychiatrically stable but need more structure than traditional outpatient therapy provides. These programs offer a higher level of support to help clients maintain recovery progress while still living at home and participating in work, school, or family life.
IOP is ideal for individuals who:
Are medically stable and do not require daily monitoring.
Are psychiatrically stable and able to apply coping skills outside of treatment.
Can function in social, educational, or work settings with some support.
IOP treatment typically includes:
Structured programming for a few hours per day, 2–5 days a week
Meal support several times a week
Individual and Group therapy
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Partial Hospitalization Programs (PHP) or Day Treatment
Partial Hospitalization Programs (PHP) offer a more intensive level of care than IOP. This option is helpful when symptoms significantly interfere with daily life, even if the individual is not in immediate medical danger. PHPs are often a bridge between residential care and outpatient therapy.
PHP is ideal for individuals who:
Are medically stable but require frequent health monitoring.
Are psychiatrically stable but need regular support for mental health management.
Struggle to function in daily life due to eating disorder symptoms like:
Frequent bingeing, purging, or restricting
Disordered thoughts around food or body image
PHP treatment typically includes:
Full-day structured treatment 5–7 days a week
Supervised meals and snacks
Daily therapy sessions
Returning home each evening
Residential Eating Disorder Treatment
Residential programs offer 24/7 support in a non-hospital setting for individuals whose symptoms have not responded to outpatient or partial hospitalization care. These programs provide round-the-clock structure while allowing for a more home-like environment.
Residential care is ideal for individuals who:
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Are medically stable but need constant therapeutic support.
Are psychiatrically compromised, with symptoms interfering with safety or daily functioning.
Have not made progress in lower levels of care or require intensive stabilization.
Residential treatment typically includes:
Living on-site at the facility
24-hour care and supervision
Daily therapy, meal support, and psychiatric care
Medical monitoring without the need for hospitalization
Inpatient Hospital-Based Eating Disorder Treatment
Inpatient eating disorder treatment is the highest and most intensive level of care, typically provided in a hospital setting. It is designed for individuals facing life-threatening medical or psychiatric symptoms that require immediate stabilization.
Inpatient treatment is appropriate for individuals who:
Are medically compromised, experiencing:
Unstable vital signs
Acute medical complications (e.g., dehydration, cardiac issues, diabetes)
Dangerous lab results
Are psychiatrically compromised, showing:
Suicidal thoughts or inability to commit to a safety plan
Rapidly worsening mental health
Inpatient treatment typically includes:
24-hour medical and psychiatric monitoring
Hospital-based care for medical stabilization
Transition planning to step down to residential or PHP once stable
Recovery Is Possible
The guidelines help us understand that early intervention, culturally sensitive care, and personalized treatment approaches lead to better outcomes. Every person’s recovery journey is different. If you're unsure which level of care is right for you or a loved one, know that you're not alone. At Monarch Wellness & Psychotherapy, we’re here to help guide you with compassion and professional support.
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We offer in-person and virtual telehealth counseling in Maryland, Virginia, and Washington DC, as well as virtual telehealth counseling across Psypact states. Our therapists can work collaboratively with other members of your health team to find a plan that supports your unique recovery journey. Learn more about treatment here and about finding treatment providers in your area here.
Reach Out
If you’re considering professional support, we’re here to help. Please reach out to schedule a free, no-commitment consultation. There’s no fee and no obligation—just click the button below to get started.
You can also call or text us at 202-656-3681, or email us directly. Give yourself the opportunity for the support you deserve.