Hospitalization for Eating Disorders

Eating disorders can be extremely dangerous and potentially deadly illnesses. Research indicates that anorexia has the highest mortality rate of any mental health condition, and 10,200 people die each year due to an eating disorder. Because of this, hospitalization for eating disorders is sometimes necessary to help stabilize a person's condition.

People with eating disorders frequently experience medical complications, which can affect all systems of the body. As a result, sometimes people with eating disorders, including anorexia nervosa and bulimia nervosa, may require treatment in a hospital or residential treatment center (RTC).

Overview of Hospitalization for Eating Disorders

Inpatient hospitalization is the most intensive level of treatment. The main reason for inpatient hospitalization is medical instability. As a result, eating disorder patients needing inpatient hospitalization are often admitted to specialized units rather than general psychiatric units where patients with other mental disorders are usually treated.

Whenever possible, eating disorder hospitalization should take place in a specialized unit for eating disorders versus in a general medical or psychiatric unit. Eating disorders require a unique collaboration between many medical and mental health specialists, and general hospital units may not be set up to provide the appropriate care.

Considerations for Hospitalization for Eating Disorders

Because hospitalization is very expensive, it is usually short-term. Many patients only stay at the inpatient level of care until they have been medically stabilized enough to continue treatment at a lower level of care.

The medical management available at the inpatient level is very important. Many patients require monitoring of vitals, intravenous fluids, tube feeding, medication, and laboratory tests.

It may also include other specialists if needed. Inpatient units are often connected to or affiliated with a full hospital which can provide access to different medical specialists, including cardiologists, neurologists, gastroenterologists, etc.

Hospital staff also will provide basic nutrition information and nutritional counseling, and a dietitian will plan meals. If the patient can't eat enough to regain or maintain weight, doctors and other treatment team members may recommend medical refeeding, which involves inserting a tube through the patient's nose down into the stomach.

This tube then can carry nutrition directly to the stomach. Medical refeeding is one of the unique services that inpatient hospitalization is able to provide. Another form of support that inpatient hospitalization is able to provide is supported meals. Staff members will typically supervise all of a patient’s meals to provide support and monitor intake.

They will be available before and after meals, to process any urges that patients are experiencing and to support patients during these anxiety-provoking times. Hospitalized patients will also receive counseling with a therapist and an evaluation by a psychiatrist.

When Might Someone Be Hospitalized for an Eating Disorder?

Any time a person is experiencing medical complications due to their eating disorder including but not limited to an unstable heart rate or blood pressure, fainting, or bleeding from vomiting, they should be screened for hospitalization. Patients may require hospitalization if they are severely malnourished and/or have lost a great deal of weight and are at risk for refeeding syndrome.

Patients may often be transferred to residential treatment or a partial hospitalization program when their vitals are stable, they have resumed eating on their own with structure, and they have gained some weight.

They may still require high levels of support and structure, but this can usually be provided at a nonmedical residential treatment center or a partial hospitalization program, which a patient attends during the day but returns home at night to sleep.

Residential Treatment Centers

Residential treatment centers also house patients 24 hours a day, but these are non-medical facilities that provide housing, meals, and multidisciplinary treatment.

It can also be appropriate when someone is suicidal (although if there are any imminent concerns for suicide, this is an indication for inpatient hospitalization), if the patient lives far away from treatment providers, if there is a lack of social support, or if there are other complicating medical or psychiatric factors.

The goal of residential treatment is to improve physical and psychological health. The average length of stay in a residential treatment center is 80 days. Patients receive supervised meals. Intensive psychotherapy, or counseling, is usually a routine part of residential treatment.

Because patients are at residential treatment centers 24 hours a day, seven days a week, patients may be able to have sessions with therapists more frequently than on an outpatient basis. In some centers, they may be able to meet with their individual therapist several times during the week. They will also usually attend group therapy sessions and family therapy sessions.

How Hospitalization Fits in the Continuum of Care

The full continuum of care for eating disorders includes outpatient care, intensive outpatient programs (IOP), day treatment or partial hospital programs (PHP), residential programs, and inpatient hospitalization. A patient may move in either direction through the varying levels of care based on factors including symptom severity, medical status, motivation, past treatment history, and financial abilities.

Takeaways

Hospitalization is one option in the treatment of eating disorders. Medical hospitalization is considered the highest level of care. It is the most expensive option, and tends to be used when a person needs medical stabilization. One a person's condition has been stabilized, they are then moved to a lower level of care, such as residential or inpatient treatment, partial hospitalization, intensive outpatient treatment, or outpatient treatment.

If you or someone you love has an eating disorder, talk to your doctor about which treatment options are right for you. With the appropriate care, you can get the help and support you need to overcome your eating disorder and live a healthy life.