How Long Is Eating Disorder Treatment?

Beginning eating disorder treatment can feel overwhelming. Your mind is likely swirling with questions: Will this work? What will life in recovery look like? Can I do this? And one question that tends to come up frequently is, how long will this take? It’s natural to wonder about this. When you’re embarking on something as big and unknown as eating disorder recovery, it can be a comfort to know how long it will last, to have an endpoint that you can look toward. So let’s get into it: how long is eating disorder treatment, really?

How long is eating disorder treatment? It depends.

As much as we might wish there were one, clear-cut answer, the reality is that the length of eating disorder treatment is highly variable and depends on a number of different factors. “Eating disorder treatment length can vary widely,” says Kathryn Coniglio, PhD, Program Development Lead at Equip. For higher levels of care—like inpatient, residential, or partial hospitalization programs—she explains that an individual stay can vary from a few weeks to a year or more, citing a recent review paper that found that the average length of stay in residential treatment centers ranged from 17 days to 377 days.

Often, but not always, the more intense a program is, the shorter it is: for instance, someone may be in a partial hospitalization program (that might meet five days a week, eight hours a day, for example) for four weeks, and then step down to an intensive outpatient program (that might meet four days a week for three hours) for eight weeks.

“It’s also important to remember that a patient’s entire recovery journey may involve receiving treatment in several of these settings,” says Coniglio. “In many cases, these people have been living with their eating disorder for a long time before they were connected to care.“ Indeed, research has shown that recovery is nonlinear and can occur over the course of years. (In my own treatment journey, I had many different lengths of stay at many different treatment facilities—inpatient for three weeks, IOP for the duration of one summer, PHP for a semester’s length of care, residential for several months, outpatient for years—before finally achieving recovery.)

One of the reasons that recovery can take such a long time is because relapse is unfortunately common for eating disorders, and so treatment needs to account for that. One study referred to relapse prevention as “a matter of essence” for recovery from anorexia nervosa, and recommended that all patients with anorexia develop a personalized relapse prevention plan at the end of their treatment and be monitored for at least 18 months after discharge. Read more about what relapse prevention looks like at Equip.

However, this doesn’t mean that eating disorder treatment is always a matter of years. “There are several approaches that are delivered in an outpatient setting that can successfully treat eating disorders in a much shorter time frame,” says Coniglio. Two of those approaches, she says, are family-based treatment (FBT) and cognitive behavioral therapy (CBT), both of which have evidence supporting their effectiveness over relatively short time periods. “These treatment modalities can be used with a variety of eating disorder diagnoses and have been shown in clinical research trials to lead to symptom remission in just a few months,” she explains.

Factors that influence the length of treatment

Eating disorders look different from person to person, and so does eating disorder recovery. Two people who seem exactly the same on paper—same age, same diagnosis, same demographic details—might have very different needs when it comes to length of treatment.

However, there are a few factors that tend to influence how long treatment takes:

  • Age: Some research has shown that patients who begin treatment at a younger age need treatment for a shorter amount of time than older patients.
  • Weight: One meta-analysis found that a lower weight at admission was associated with longer length of treatment, while another study found that for patients with anorexia, admission weight was associated with a longer length of stay.
  • Co-occurring conditions: Treatment modalities like FBT and CBT are flexible enough to address co-occurring conditions like depression, anxiety, or OCD in the context of eating disorder treatment, Coniglio explains. Some providers may opt to treat each condition sequentially, which may prolong overall length of treatment, but, she says, “the addition is a few weeks or months, not years!” Both options are supported by data.
  • Duration of illness: Some research shows that the longer someone has struggled with an eating disorder, the longer they’ll need to remain in treatment (which is part of the reason that we always advocate for early intervention). However, Coniglio points out, “a delay in a patient’s ability to access high-quality care affects illness duration. There are so many barriers that contribute to this delay, including the cost and accessibility of treatment. So it’s difficult to tease apart whether illness duration itself affects treatment length, or whether the gap between eating disorder diagnosis and access to treatment is to blame.”

But regardless of any of these factors, it’s important to remember that lasting recovery is possible for everyone affected by an eating disorder. “No matter how long it may take, there’s strong evidence that recovery is within reach for folks no matter their age or diagnosis at the start of their treatment journey,” says Coniglio.

How long is Equip treatment?

“Treatment length is different for everyone at Equip. Recovery is highly personal and there is no one-size-fits-all approach,” explains Coniglio. However, she says, our data shows that patients generally see results quickly. “After just two months at Equip, 80% of patients show a decrease in eating disorder symptoms and nearly 40% of patients report no eating disorder symptoms at all,” she says. “This is especially exciting to consider in light of the fact that 59% of our patients come to Equip after having had at least one prior treatment. In other words, many of our patients who experience this rapid symptom reduction have been struggling with their eating disorder for a long time.”

We also take an integrated approach to treatment—meaning we offer a range of resources for treating co-occurring conditions while patients are at Equip—which, as Coniglio mentioned, can shorten the duration of treatment. “Equip has many treatment offerings for treating conditions that frequently co-occur with eating disorders, like anxiety, perfectionism, obsessive-compulsive disorder, and emotion regulation,” she says. “We believe treating the whole person helps set our patients up for sustained recovery.”

Equip treatment works—and it starts working quickly—but that doesn’t mean that patients are in and out of treatment in a matter of weeks or a couple months. While recovery looks different for everyone, we generally seek insurance authorization for up to a year of treatment for all patients at Equip.

A year might seem like a lot of time, but the intensity of treatment doesn’t remain the same for the whole duration. You’ll start off with frequent weekly appointments, but they become less frequent as you make progress and move toward recovery. Most patients achieve remission (meaning their eating disorder symptoms are gone, they’ve reached their target weight, and they’re eating normally) before the year is over, and then have the support of their provider team as they navigate those vulnerable first few months in recovery. This provides a safety net, allowing them to taper down support in a gradual and thoughtful way that protects against relapse.

Ultimately, the length of eating disorder treatment is less important than ensuring that treatment thoroughly and effectively addresses the eating disorder. How long this takes will vary from person to person, but by using an evidence-informed and individualized approach, providers can help patients reach recovery more quickly than they might otherwise. “Because eating disorders are life-threatening illnesses, it’s so important for providers to use treatment approaches that prioritize making behavior changes as early as possible in treatment,” says Coniglio. “But the optimal length of treatment is the length it takes for eating disorder symptoms to resolve.”

Lasting recovery is possible for everyone struggling with an eating disorder—and with the right support, it can happen sooner, rather than later.

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References
  1. Peckmezian, Tina, and Susan J Paxton. “A systematic review of outcomes following residential treatment for eating disorders.” European eating disorders review : the journal of the Eating Disorders Association vol. 28,3 (2020): 246-259. doi:10.1002/erv.2733
  2. Eddy, Kamryn T et al. “Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up.” The Journal of clinical psychiatry vol. 78,2 (2017): 184-189. doi:10.4088/JCP.15m10393
  3. Berends, Tamara et al. “Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study.” BMC psychiatry vol. 16,1 316. 8 Sep. 2016, doi:10.1186/s12888-016-1019-y
  4. Kan, Carol et al. “Length of stay for anorexia nervosa: Systematic review and meta-analysis.” European eating disorders review : the journal of the Eating Disorders Association vol. 29,3 (2021): 371-392. doi:10.1002/erv.2820
  5. Kästner, D et al. “Factors influencing the length of hospital stay of patients with anorexia nervosa - results of a prospective multi-center study.” BMC health services research vol. 18,1 22. 15 Jan. 2018, doi:10.1186/s12913-017-2800-4
  6. Austin, Amelia et al. “Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature.” European eating disorders review : the journal of the Eating Disorders Association vol. 29,3 (2021): 329-345. doi:10.1002/erv.2745
Kate Willsky
Senior Manager, Content
Clinically reviewed by:
Kathryn Coniglio, PhD
Program Development Lead
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