Choosing Eating Disorder Treatment: A Parents’ Guide

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If a young person is living with an eating disorder or disordered eating, they need to access effective treatment as soon as possible. But with a global shortage of eating disorder beds, many young people are unable to enter treatment programs, and government health systems often turn teenagers and adolescents down because they are “not sick enough”.

In response to the lack of specialist treatment, other treatment providers have begun opening their doors to young people with eating disorders, sometimes without the expertise or high level of medical care required.

Unfortunately, this means that while many centres do offer reliable and effective treatment, some programs are less effective and may prevent young people from achieving the recovery they deserve.

Eating disorders are serious conditions that cause harm to the mental, physical, and social lives of young people. There’s no such thing as a “mild” eating disorder and some types of eating disorders can be fatal if left untreated. This means that understanding how to choose good treatment is really important. 

This guide helps parents and other family members to know what questions to ask and what answers to look for. It explains what effective eating disorder treatment should include to give young people the best chance of reclaiming a healthy and happy future.

Does The Facility Specialise in Eating Disorder Treatment?

Eating disorders are complex conditions that require specialist support and a high level of medical care. This means that providers who treat eating disorders as a small part of their programs are unlikely to have the resources or expertise required for effective care.

Instead, you should look for a centre that specialises in eating disorders: as a rule of thumb, in a general psychiatric treatment program, at least half of the program and half of the program places are dedicated to people with eating disorders.

Some treatment providers that lack specialist support may claim to cater towards “mild eating disorders”. But in reality, all eating disorders are serious conditions that require expert care, regardless of a young person’s body shape, weight, or the length of time that they have had the disorder. 

Can They Provide Medical Interventions?

Many young people with eating disorders develop physical or mental health issues that require medical intervention. This can happen as a result of a low body weight, consuming too little energy, electrolyte deficiency, damage to the digestive system, and other consequences of eating disorders. In some cases, severe health problems need urgent, and even life-saving, interventions.

When choosing an eating disorder treatment facility, it’s important to check if they can intervene medically if it’s necessary, keeping young people safe at all times.

Ask for Qualifications and Specialist Training

When searching for a treatment provider, look for specialist training qualifications such as IAEDP, CBT-E, FBT, FREED, and MBT-ED. Don’t hesitate to ask for certificates and registration numbers to prove that the qualifications are valid.

What Support Do They Offer at Mealtimes?

Mealtimes play an important role in recovery from eating disorders. They are often challenging for young people, but with the right support, teenagers and adolescents can develop healthier eating routines and start to replace emotional distress with enjoyment and nourishment.

Effective treatment programs should include supported dining, including plated meals and observations by professional team members. You may want to ask how mealtime support takes place and what safety measures are implemented around mealtimes. You could request sample menus at different calorie portioning to have a clearer idea of what meals may look like.

What Are the Overnight Observations? 

When young people have serious eating disorders, they need to be closely monitored to check for physical health issues. Conditions like low blood glucose, low blood pressure, and a low pulse can develop or worsen at any time, including during the night. It’s important that doctors make overnight observations to quickly identify and treat any medical complications if they develop.

How Does the Team Balance Movement and Exercise? 

When young people have a very low body weight, movement and exercise need to be strictly limited. During these stages, when calorie intake is also often very low, young people need to use as little energy as possible to allow their bodies to survive, repair, and recover.

As treatment progresses, or for lower-risk cases, teenagers and adolescents may be able to engage in more exercise and physical activities. It’s usually still helpful to clearly outline the amount of exercise a young person can do each day and how it will be scheduled.

Doctors, psychologists, and nurses also need to consider that many young people use exercise as a way to maintain a low body weight and therapeutic sessions should address the way that teenagers and adolescents perceive exercise.

As young people recover, they may be able to benefit from some of the positive effects of exercise, if it is introduced safely. Activities like yoga or trauma-informed yoga can play a role in long-term recovery, treating mental health issues or mind-body feelings that may underlie disordered eating behaviours.

For example, yoga may be able to help young people to manage difficult emotions for which they have otherwise used food as a coping mechanism. Effective eating disorder treatment programs should be able to assess the risks and benefits to a young person and carefully balance movement and exercise with rest and physical recovery.

What Protocols Are in Place for Refeeding Syndrome?

Refeeding syndrome can happen when a young person who is severely malnourished starts consuming more food. When refeeding is not properly managed, it can cause several serious medical consequences and complications, such as confusion, depression, impaired muscle contraction, and cardiac arrest.

While refeeding syndrome can be very dangerous, it can be prevented through certain protocols. These include:

  • supplements of phosphate, thiamine and multivitamins
  • gradually increasing the nutritional intake of a young person, beginning with a balanced diet containing enough protein and fat

While it’s important to increase food intake slowly, it’s also crucial to avoid underfeeding. Providing nutritional supplements and adequate protein and fat (or reducing carbohydrate intake) can help to lower the risk without reducing feeding too much. Doctors should monitor young people at least twice a day to check for signs of refeeding syndrome.

Is the Facility Equipped to Prevent Emergencies and to Act Quickly in High-Risk Cases?

Some medical complications of high-risk eating disorders require a rapid medical response. This might happen with a low pulse, body temperature, blood pressure, or postural drop.

In these cases, facilities need to be able to act quickly to provide the treatment and care required. This means having the relevant medical equipment, including intensive care provision, and round-the-clock access to medical support. It might also mean quick and reliable transport to a nearby hospital with appropriate medical facilities.

Do They Comply with ED Guidelines for Care? Which Country’s Guidelines Do They Follow and Are They Published?

Eating disorder guidelines for care are designed to make sure that treatment providers provide effective support that promotes long-term recovery while ensuring the safety of young people.

When you’re choosing treatment, it’s important to look for a centre that complies with these guidelines.

That said, not all countries have the same standards for eating disorder care and some may leave room for inadequate treatment. You may want to ask which country’s guidelines they follow and request to see them – this allows you to check that their guidelines are similar to trusted policies of other countries. 

Does the Treatment Provider Primarily Treat Addictions?

Some adult addiction facilities also offer eating disorder treatment in their programs. They may claim that the pathology of eating disorders is close to the pathology of addictions and that similar treatment programs may be effective for both.

In reality, eating disorders have nothing in common with addictions. It’s a good rule of thumb that an adult addiction clinic is unlikely to treat addiction disorders successfully.

Programs that encourage a 12-step model (an established treatment method for addictions) may instead enforce new ‘rule’ books that support restriction and unwittingly sustain disordered eating behaviours.

Are Treatment Programs Sufficient in Length?

While it’s normal to want a young person to recover as quickly as possible, programs that are too short are unlikely to achieve long-term recovery. Treating eating disorders requires addressing the disorder’s pathology and changing the thought and behavioural patterns that drive or underlie disordered eating behaviours.

This process requires time, sensitivity and care. Young people need the space to introspect, reconnect, and heal while learning and reinforcing new skills.

This means that 28-day ‘programs’ are very unlikely to reset or change the pathology of an eating disorder. Longer treatment courses – usually of at least three months – are necessary to help young people reclaim and sustain the healthy life that they deserve.

Are They Equipped to Common Co-Occurring Disorders? Are Their Programs Neurodiverse-Informed?

Many young people with eating disorders also live with co-occurring mental health disorders or neurodiverse disorders like borderline personality disorder, autistic spectrum disorder, and ADHD.

Co-occurring disorders may underpin disordered eating behaviours and complicate the treatment process, affecting the way that young people engage with and benefit from therapy.

Effective recovery programs should treat co-occurring disorders alongside eating disorders, promoting recovery of the entire person that remains strong and stable.

They should also understand how neurodiversity can affect the way a young person responds to treatment and adapt programs accordingly, offering specialist support where necessary.

Look Out for Myths About Eating Disorders

Some treatment providers base their programs on inaccurate information and false conceptions of the conditions. For example, some clinics claim that eating disorders are related to white flour or refined sugars.

In truth, eating disorders have nothing to do with these foods but develop from a complex set of factors including genetic factors, personality traits, childhood adversity, stressful life events, and media influence.

The Wave Clinic: Expert and Specialist Eating Disorder Treatment for Young People

The Wave Clinic offers specialist eating disorder treatment for young people, supporting them to build fulfilling futures. Our whole-person approach combines exceptional clinical care with education, social responsibility, and a gap year experience, helping young people reconnect with their love and lives and develop the skills they need to follow their dreams.

The Wave’s team is trained in all eating disorder-focused modalities and our medical director, Dr. Rasyid, is a leading eating disorder psychiatrist. We operate according to UK guidelines, providing over four levels of care that encourage increasing independence.

We are a leading eating disorder specialist trusted by mental health professionals and families worldwide and have successfully treated hundreds of complex presentations.

Our Main House is a specialist eating disorder program able to care for the most complex cases that require intensive treatment and one-to-one medical intervention. If you’re interested in finding out more about our programs, contact us today. We’re here to help.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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