Treating Eating Disorders at Higher Levels of Care: Overview and Challenges

Abstract

Higher levels of care (HLC)-including inpatient hospitalization, residential treatment, partial hospitalization, and intensive outpatient treatment-are frequently utilized within routine care for eating disorders. Despite widespread use, there is limited research evaluating the efficacy of HLC, as well as clinical issues related to care in these settings. This review describes the different levels of care for eating disorders and briefly reviews the most up-to-date guidelines and research regarding how to choose a level of care. In addition, as HLC approaches for ED continue to be developed and refined, pragmatic and conceptual challenges have emerged that provide barriers to clinical efficacy and the execution of high-quality treatment research. This review includes a discussion of various issues specific to HLC, as well as a summary of recent literature addressing them.

Sexual and gender minority individuals report higher rates of abuse and more severe eating disorder symptoms than cisgender heterosexual individuals at admission to eating disorder treatment

“…On the contrary, while both groups improved, in the unadjusted model, SGM patients experienced a significantly faster improvement in symptoms during the first treatment phase compared to CH peers. Evidence of treatment success for both SGM and CH‐identifying individuals is itself, however, an important and encouraging finding given the limited research available on treatment effectiveness in the residential treatment setting (Anderson et al, ). Future research should aim to test the specific components of a treatment intervention to better understand what elements make a program effective, particularly for the SGM population—in this case so much that there were no significant differences between the ED symptom severity of SGMs and CHs upon discharge.…”

Efficacy of a partial hospital programme for adults with eating disorders

“…As such, higher levels of care are often necessary to facilitate recovery, especially for patients with a long‐standing duration of illness who have not responded to weekly outpatient treatment (Anderson et al, ). Partial hospital programmes (PHPs) are recommended for those whose symptoms are too severe to be treated by a traditional outpatient team, but who do not require hospitalization for medical stabilization or a residential setting for complete containment of behaviours.…”

Contingency Contracts for Weight Gain of Patients with Anorexia Nervosa in Inpatient Therapy: Practice Styles of Specialized Centers

“…Motivational aspects are one of the main considerations for the improvement of treatment and care for patients with AN [ 27 ] and are taken into consideration for example by integrating motivation-based therapeutic styles into treatment [ 28 , 29 ]. Motivation of patients has been shown to play an essential role concerning dropout rates and treatment compliance [ 30 ].…”