Understanding the Different Levels of Care for Eating Disorders
Eating disorders are complex, serious medical and psychological illnesses that require individualized treatment. Because the severity of eating disorders can vary widely, treatment is offered at different levels of care—ranging from outpatient therapy to full medical hospitalization.
Knowing the appropriate level of care is essential for safe recovery, medical stability, and long-term healing. In this guide, we’ll break down each level of care, what it involves, and how to determine which one may be right for a particular situation.
Why Different Levels of Care Exist
Eating disorders affect physical, emotional, and behavioral health. Individuals may fluctuate in their ability to manage meals, medical symptoms, and psychological distress. Levels of care are designed to:
Provide the right intensity of support
Address medical and nutritional stability
Offer therapeutic interventions tailored to current needs
Prevent relapse and hospitalization when possible
Promote safety and minimize risk of medical complications
Treatment is not linear—people may move between levels as their needs change.
Overview of Levels of Care
Level Intensity Typical Duration Who It’s For Outpatient Lowest 1–2 times/week Medically stable, mild to moderate symptoms Intensive Outpatient Program (IOP) Moderate 3–5 days/week, 3–4 hours/day Needs more support than outpatient, still medically stable Partial Hospitalization (PHP) High 5–7 days/week, 6–10 hours/day Needs structured meals and therapy, not requiring overnight care Residential Treatment 24/7 Support (non-hospital) Weeks to months Medically stable but unable to function in daily life Inpatient Hospitalization Highest (hospital-based) Short-term stabilization Medically or psychiatrically unstable
1. Outpatient Care
What it includes:
Individual therapy (CBT, DBT, FBT, etc.)
Medical monitoring with a physician
Nutrition therapy with a registered dietitian
Psychiatric support as needed
Best for:
Individuals who are medically stable
Mild to moderate symptoms
High motivation for recovery
Safe home environment with strong support
Goals:
Behavior change through therapy
Weight and symptom stabilization
Nutritional education and support
2. Intensive Outpatient Program (IOP)
What it includes:
Group therapy, meal support, nutrition counseling
Typically after school or work hours
Family therapy in pediatric/teen programs
Best for:
Those who need more than outpatient, but can still live at home
Struggles with meals, urges, or motivation
Co-occurring anxiety, depression, or trauma
Goals:
Structured meal support
Skills building (e.g., coping with urges, emotion regulation)
Peer support and accountability
3. Partial Hospitalization Program (PHP)
(Also known as Day Treatment)
What it includes:
Daily structured programming (6–10 hours/day)
Supervised meals and snacks
Medical and psychiatric monitoring
Family support and therapy (especially in adolescents)
Best for:
Individuals who are medically stable but unable to maintain recovery on their own
Those at risk of hospitalization if not supported
Transitioning down from residential or inpatient care
Goals:
Restore physical and nutritional stability
Practice recovery skills in a highly structured setting
Prepare for outpatient or IOP level
4. Residential Treatment
What it includes:
24-hour care in a non-hospital setting
Full multidisciplinary team: medical, therapy, nutrition, psychiatry
Daily group therapy, meal support, school services (if pediatric)
Best for:
Individuals who are medically stable but emotionally or behaviorally unable to function outside of treatment
Severe eating disorder symptoms
Safety concerns or repeated treatment failure at lower levels
Goals:
Round-the-clock support
Comprehensive treatment and meal normalization
Focus on underlying emotional and psychological factors
5. Inpatient Hospitalization
What it includes:
24/7 medical monitoring in a hospital
IV fluids, nasogastric (NG) tube feeding if needed
Psychiatric stabilization
Often very short-term (days to a few weeks)
Best for:
Acute medical instability (e.g., low heart rate, electrolyte imbalance)
Risk of self-harm, suicidality, or refeeding syndrome
Step before entering residential or PHP
Goals:
Medical stabilization
Address immediate life-threatening complications
Facilitate transition to lower level of care for long-term recovery
How Is Level of Care Determined?
A comprehensive evaluation from a team—including a physician, therapist, and dietitian—is needed. Factors include:
Medical stability (vitals, labs, weight trends)
Nutritional intake and restriction behaviors
Psychiatric risk (e.g., suicidality, self-harm)
Behavioral symptoms (e.g., purging, over-exercise)
Motivation and support at home
Tools like the American Psychiatric Association Guidelines and The Society for Adolescent Health and Medicine criteria can help guide clinical decisions.
When to Step Up or Down Levels of Care
Step up when:
Medical or psychological safety is compromised
Weight or symptoms worsen
Outpatient care isn’t effective despite efforts
Daily functioning is disrupted (school, work, relationships)
Step down when:
Stable vitals and symptoms
Increased coping skills
Meals and behaviors managed consistently
Able to reintegrate into daily life with support
Final Thoughts
Each level of care plays a unique and valuable role in eating disorder recovery. There's no shame in needing more support—and no failure in stepping up when necessary.
Recovery is not linear. The most important thing is receiving care that is safe, appropriate, and tailored to your needs. With the right support at the right time, healing is not only possible—it is sustainable.
References
American Psychiatric Association. (2023). Practice Guidelines for the Treatment of Patients with Eating Disorders.
Mehler, P. S., & Andersen, A. E. (2017). Eating Disorders: A Guide to Medical Care and Complications.
Society for Adolescent Health and Medicine. (2015). Position Statement on Eating Disorders in Adolescents.
Lock, J., & Le Grange, D. (2015). Treatment Manual for Anorexia Nervosa: Family-Based Therapy.
National Eating Disorders Association (NEDA). nationaleatingdisorders.org
