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Help and support

Are you thinking about seeking help and support? There are lots of resources available and you do not need to battle an eating disorder on your own. Getting help can at first seem overwhelming and we hope to allay some of your fears on this page. We recommend taking a look at our support area after you have read the information here. You can often find treatment options in the phone book, by searching online or by contacting your local medical facility. You can also find many treatment options by using our treatment finder.

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Treatment options

Fortunately, the days of "fattening up" and releasing patients are long gone. In the past, eating disorders were thought of as being purely physical illnesses, so the psychological aspects were often ignored. Inevitably, this meant that most patients relapsed as soon as they came out of hospital.

Treatment nowadays tends to focus more on the individual’s mental health, which means that the cause(s) behind their eating disorder can be addressed. There are many specialized eating disorder treatment centers (particularly in the United States) and the patient may work with a multitude of different professionals including doctors, nutritionists and therapists.


General counselors/therapists

Many therapists do not specialize in eating disorders and will only be able to offer general counseling. However, they should not be dismissed, especially if the sufferer has a number of different issues to work through. For example, somebody who has been through experiences of abuse, rape and/or parental difficulties might find that a general therapist offers a more rounded approach to their issues. Also, even if you are unsure what the issues behind your eating disorder are, seeing a general therapist is a good and a positive step in the right direction.


Specialist counselors/therapists

If you can find one, a therapist who specializes in the treatment of eating disorders is often preferable. The therapist will have experience in dealing with the issues that lie behind eating disorders. They should also be up-to-date on the latest treatment techniques and will have a more thorough knowledge of the approaches required to initiate the recovery process.

One important thing to remember is that the "right" therapist is the one that is the best fit for you. You must feel comfortable with your therapist, otherwise you are less likely to trust them and want to talk to them.


Specialist treatment centers

There are many specialized eating disorder treatment centers around, especially in the United States. These usually offer a number of different programs, depending whether the person is anorexic, bulimic or an overeater. You can expect to work with one or more therapists, a nutritionist, doctors and other psychiatric professionals.

A common fear about plunging into inpatient treatment (and indeed, any treatment involving a group setting) is that there will be other sufferers there who are "thinner" than you. You are not alone in this fear but it is important to try to set it aside. Treatment centers tend to have a positive, caring environment; not one of jealousy and unhealthy competition. Remember, almost everyone will have had the same thoughts and fears as you when they first arrived!


Hospitalization

Lots of hospitals have specialist eating disorders units, and even those that do not often have a psychiatric department offering some kind of treatment or referrals. Your local hospital may offer outpatient counseling and many hospitals offer inpatient facilities as well.

It is possible to be hospitalized purely because of your physical health. This may or may not be against your wishes and can depend on your age. An individual’s weight often has to reach a dangerously low (or high) level before they are hospitalized but this is not always the case. Eating disorders bring with them many complications, any one of which could lead to an unexpected trip to the emergency room.

If necessary, the hospital will provide nutritional care in order to stabilize the individual’s weight. After this, they will typically offer psychiatric care (or least provide a referral), as well as continuing to monitor their physical wellbeing. There is no pre-determined weight a person can get to in order to be hospitalized; it varies from one individual to another.


Mental health clinics

Some hospitals specialize purely in mental health and psychiatric illnesses. They are no different to other hospitals, except that they offer more specialized services. Also, do not assume that they only offer inpatient facilities as most mental health clinics offer outpatient counseling as well.


Support groups

There are two types of support group: professionally led ones and self-help. The former will be led by an eating disorder or mental health professional, whereas the latter will consist of eating disorder sufferers and/or those in recovery and is not led by a professional. The best of examples of self-help groups are 12-step programs such as Overeaters Anonymous.

A support group is not a substitute for therapy, but is a useful supplement and enables people with similar problems to get together and share their experiences with one another. You may find that it is sometimes easier to open up to someone who has been through what you are going through. Many support groups will offer theraputic exercises and other tasks to help come to terms with the issues behind each person’s eating disorder.
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Medical insurance

Note: This information is specific to the United States but other countries may have similar insurance considerations.

Some insurance companies are far more likely to pay out for physical illnesses than mental ones. This means that it can be hard to find insurance that covers eating disorders and, with the cost of treatment often high, this can unfortunately discourage people from seeking help. The situation has improved over the last decade, with many organizations lobbying for changes in the law and some insurance companies being forced to recognize eating disorders as legitimate illnesses that need treatment.


Medicaid & Medicare insurance

Many hospitals and facilities will accept Medicaid and Medicare health insurance. However, you will need to confirm that they do indeed accept this type of insurance before proceeding with treatment.


The hospital accepts Medicaid/Medicare, but there isn’t an eating disorders program!

It is entirely possible that the hospital or facility accepts your insurance but doesn’t have the appropriate form of treatment for you. If the treatment center is a mental health facility, check whether it is partly funded by county, state or federal funds. If it is, you can ask that the relevant care be provided.


I have insurance but am unsure what to do next

If you have insurance but are not sure how to proceed, there are some important points to remember:

  • Make sure you know when coverage may end (e.g. after a few months of treatment)
  • Read the small print and know what percentage you have to pay and what the insurance company has to pay
  • Many therapists and facilities do not take insurance reimbursement as direct payment for services


What if I don’t have health insurance?

Not all treatment programs require you to have health insurance but they can be hard to find. Fortunately, many therapists offer a sliding scale fee for those who have difficulty paying or do not have insurance.

There are also other options available if you do not have insurance, such as counseling centers at work, school or community facilities. Psychiatry departments in medical schools may also offer low cost treatment for eating disorders or could refer you to a place that does.

Some hospitals and universities run free research programs from time to time. These are beneficial to the patient, who receives free treatment, and also to the facility which gains a further insight into eating disorders and possible programs for the future.


Parity law

According to the National Association of Anorexia Nervosa and Associated Disorders, only a handful of states specifically name eating disorders in their parity law. Parity law forces insurance companies to recognize both physical and mental illnesses as being of equal importance. Unfortunately, there are still over a dozen states that have no parity law whatsoever, and even those which do still tend to favor physical over mental health concerns.

Remember, even if you are in a state that has parity law, your insurer/HMO (Health Medical Organization) may have its headquarters in another state that is not obliged to provide coverage for eating disorders treatment.


Recovery

Recovery from an eating disorder is very possible. It requires some motivation but it is very much worth it in the end. You can have a life free of your eating disorder, even if it takes years of treatment.

It is possible that, even after years of recovery, some semblance of the eating disorder remains. This is very common and it could be that it is with you for the rest of your life. A goal of recovery should be to learn new coping skills and to make eating disordered behaviors be a last resort rather than a first resort.

Recovery is a process that is different for everyone because your isses will not be exactly the same as anyone elses. Some people have recovered simply through using books and other resources, but this cannot be recommended. There is no substitute for talking to someone who understands what you are going through.


Living without my eating disorder is too scary

Having to face life without your eating disorder might be terrifying. After all, it has been there for you when other people haven’t and it has been something to fall back on and something to rely on. What the recovery process will try to do is find ways for you deal with the issue(s) and cause(s) behind your illness. This means that, eventually, you will be able to face life without your eating disorder because you will have acquired a variety of different coping skills.


Relapses

Relapses are very common with eating disorders because the sufferer may not have dealt with all of the issues behind their illness. Additional counseling is often required, particularly if the relapse is severe. Even if the issues behind a person’s eating disorder have been addressed, it will not be unusual for them to go back to their old behaviors from time to time. This tends to happen during times of stress and tension. After all, they relied on their eating disorder for months, or even years, to be there for them.