Eating Disorder Treatment: In Home Transitional Support

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Eating disorders are deadly serious. Of all mental health disorders, mortality rates are highest among those struggling with eating disorders – up to 12 times higher from anorexia nervosa than death rates associated with all other causes for females 15-24 years old.[1] Add elevated suicide and cancer rates associated with eating disorders[2], and the need for long-lasting treatment is clear.

Historically, relapse rates are stubbornly high among those with eating disorders. Bulimia relapse rates within the first six months are 30-50%. For Anorexia Nervosa, relapse can be as high as 65% and is highest during the first 4 to 12 months after treatment.[3]

Despite quality treatment, and even positive family support upon returning home, the result for about half of post-treatment patients has been relapse. Traditionally, the response to relapse has been readmittance to a residential treatment facility. The financial expense and disruption of life – putting jobs, school, and families on hold for yet another 4-6 weeks – brings its own mental anguish.

Now, through the advent of technology and a national network of licensed and trained eating disorder treatment professionals, a revolution is under way in the post-treatment environment. Recently, networks of treatment specialists in almost every state have begun connecting with post-treatment clients through internet-based networks. Transitional eating disorder specialists are meeting clients in their homes, at local restaurants, on college campuses, or just off campus to provide meal support and coaching. Relapse rates and disrupted lives are being combated, with strong results.

Here are 5 Benefits of In Home/On Campus Meal Support and Coaching:

1. Reduced Relapse Rates. The bottom line for eating disorder treatment is to make it endure. Statistics show the most vulnerable period is in the first year post-treatment.[4] Initiating in home support as soon as an individual returns home can assist in managing the stressors of life.
2. Critical Motivation to Continue Recovery. Many eating disorder scholars have noted that one of the major challenges inherent in treating patients with anorexia nervosa is the marked ambivalence about recovery.[5] By providing personalized transitional support, the client maintains the added incentive of relation-based therapy. The social aspects and measurable results-based components of aftercare act as strong reinforcements of the benefits of maintaining recovery.
3. Accountability. A trusted partner and teammate in recovery is powerfully effective. Just like other aspects of life – being a member of a sports team, having a group work assignment, committing to a fitness program trainer – we respond when others are counting on and supporting us. Holding a post-treatment client accountable to a healthy routine works. There is no better way to do that than consistent, in person meal support.

4. Disrupt the Routine and Environment That Contributed to the Initial Disorder. One’s environment can be a powerful contributing factor to acquiring and maintaining an eating disorder.[6] Returning to that environment, absent any changes, may be fertile ground that can trigger a relapse. In home transitional support provides a key new element to that environment, with a psychological differentiator and outlet that would otherwise not exist.

5. Lifestyle and Financial Considerations. Individuals struggling with eating disorders have lives like everyone else – jobs, classes, families, children, and important life events to prepare for or attend. Taking 4-6 weeks repeatedly out of one’s life, away from those important commitments, can be seriously disruptive. This can produce stress and anxiety. If one is struggling with an eating disorder, returning to treatment can be extremely deflating. Additionally, treatment can cost an individual or their family tens of thousands of dollars, putting yet more stress on the family. With in home support, life disruption is minimal to non-existent, and the cost of this transitional care is a fraction of residential or partial hospitalization care.

For those in the eating disorder community, it is an exciting time as progress is being observed. Residential treatment facilities save lives and can produce outstanding results. Once the client leaves that controlled environment, it is encouraging to know that new technology is enabling in home meal support and therapy, extending the value gained in treatment. The ultimate goal is to extend those gains forever and reduce relapse rates toward zero.

[1] National Association of Anorexia Nervosa and Associated Disorders

[2] https://www.nationaleatingdisorders.org/mortality-and-eating-disorders

[3] http://eatingdisordersreview.com/nl/nl_edr_24_1_4.html

[4] Primary Care: A Collaborative Practice, By Terry Mahan Buttaro, JoAnn Trybulski, Patricia Polgar Bailey, Joanne Sandberg-Cook

[5] International Journal of Eating Disorders. 2008; 41:368

[6] http://eatingdisorder.org/eating-disorder-information/underlying-causes/

Greta Gleissner is the Co-founder of Eating Disorder Recovery Specialists, a nationwide network of eating disorder treatment specialists that provide meal coaching and recovery skills such as CBT, DBT, ACT, MI, etc. EDRS work alongside treatment programs, teams and families to provide transitional aftercare support for post-residential treatment clients.