Inpatient vs. Residential Eating Disorder Treatment: How to Determine Which is Necessary

Eating disorders are serious mental health conditions that require specialized treatment to overcome.

Yet, while all eating disorders call for professional care, the conditions occur at varying levels of severity, making different levels of treatment more appropriate for certain patients or at various points in the recovery journey.

Inpatient and residential treatment are generally both used to treat severe eating disorder cases, though the two types of treatment have subtle—but important—differences.

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    Residential vs. Inpatient Treatment

    There are several levels of care for eating disorders, ranging from hospitalization, in the worst cases, to outpatient treatment in the most controlled cases. Yet, while there are clear differences between many of these levels, residential and inpatient treatment are often mixed up or lumped together in the same category.

    As such, many people don’t fully understand the differences between residential vs. inpatient treatment, but learning more about the two can go a long way toward making a more informed decision about which level of care is right for you or your loved one.

    What Is Inpatient Treatment?

    Sometimes also referred to as inpatient hospitalization, this level of care is the most intensive form of eating disorder treatment.

    At the point of inpatient treatment, patients are experiencing severe eating disorder symptoms and related mental, physical, and emotional health problems. Patients at this level of care are generally considered medically unstable and are often facing an immediate risk of death.1

    The idea behind inpatient treatment is securing these patients in a clinical setting, where they have access to 24-hour medical care and monitoring. This constant care and surveillance often focus on alleviating immediate health threats.

    As such, inpatient treatment usually takes place in a hospital or a specialized wing of a medical facility. Some common treatments include nasogastric tube feeding and other measures to help a patient gain weight and medically stabilize.2

    Residential treatment

    What Is Residential Treatment?

    Residential treatment is generally considered the second-most intensive form of eating disorder treatment. One reason it often gets confused with inpatient care is that it also involves a patient staying full-time at a treatment facility, though when examining residential vs. inpatient treatment, there are a number of differences.

    While inpatient care works to help with immediate health threats, residential treatment is more targeted toward long-term recovery. As such, stays at these facilities are usually longer—ideally lasting a minimum of 30 days—and facilities are usually more comfortable and home-like, as opposed to clinical, as a result.1

    Patients undergoing residential care also usually have access to a wider variety of treatments. Since these facilities focus on long-term progress, psychiatric care is usually introduced at this level of treatment, though patients will likely still undergo medical and nutritional care. Some residential treatment programs may also offer specialized care or recreational activities.

    Inpatient vs. Residential Treatment: Which Is Best?

    When it comes to eating disorder treatment, there is no “best.” Each level of care has different advantages for people, depending on which stage of the recovery process they’re in.

    When it comes to residential vs. inpatient treatment, the general consensus is that inpatient treatment should be reserved for the most severe cases. This includes patients who are considered in a state of mental or physical crisis or at a high risk of death.3

    Residential treatment is still generally recommended for people with more severe cases, though not necessarily for those who require as much around-the-clock medical attention. Residential treatment centers involve 24-hour monitoring and support and can respond anytime in case of medical emergencies. However, patients at this stage are generally considered medically stable or sometimes required to be in order to enter the program.1

    Other Levels of Care for Eating Disorder Treatment

    Inpatient and residential rehab are not the only types of eating disorder treatment. People struggling with these conditions can—and often do—go through various levels of care, depending on their current level of physical and mental health.

    Partial Hospitalization Programs

    Partial hospitalization programs (PHPs) can be used to step down from residential programs and are sometimes recommended instead of residential care.1 That’s because these programs are also intensive, involving many hours of treatment a day, most days of the week.

    Patients in partial hospitalization programs undergo many of the same types of care as those in a residential program, including individual and group therapy sessions, nutritional counseling, and medical check-ups. The main difference is that patients in a PHP live at home and commute to treatment.

    This arrangement makes PHPs more flexible than residential programs, which is beneficial for many patients. It also usually results in less costly care, though the cost of eating disorder treatment depends on a number of individual factors. As patients make progress throughout their treatment, their schedules are modified accordingly.

    Outpatient Programs

    Outpatient programs are the least intensive type of eating disorder treatment, involving regular or semi-regular meetings with a therapist or other treatment specialist and sometimes additional medical check-ins. As such, this level of care is recommended for those who are mostly in control of their disordered thoughts and behaviors.

    Those who are ready for outpatient but need more support can enroll in an intensive outpatient program (IOP). This hybrid form of treatment is a stepped-up version of outpatient care, which involves more or longer treatment sessions and/or additional types of care, such as support groups.

    In any case, at the point of outpatient treatment, patients ideally need therapy as a means to check in with themselves, monitor for potential triggers, and remain recovery-focused.

    Virtual Eating Disorder Treatment

    In an increasingly digital world, virtual eating disorder treatment has also become a popular option for many people.

    Utilizing websites, apps, text messaging, video chats, and other forms of digital correspondence, virtual eating disorder treatment allows patients to access care from the comfort of their own homes—or wherever they can find an internet connection.

    Though relatively new, the method has already proven equally effective as in-person care for patients in outpatient and partial hospitalization programs.4 The online format makes eating disorder treatment more widely available, convenient, and cost-effective for many patients.

    How to Choose Which Eating Disorder Treatment is Right for You

    When dealing with a mental illness as physically, emotionally, and mentally taxing as an eating disorder, it can be difficult to determine which level of care is most appropriate for you or your loved one. That’s why the decision is best left to healthcare professionals.

    When pursuing help for an eating disorder, the first step is usually securing an official diagnosis from a licensed practitioner. This professional can then help you determine the next best steps, including which level of eating disorder care may be most appropriate.

    In many cases, insurance coverage will also play a part in which program or treatment level you choose. However, if the insurance company disagrees with the doctor’s recommendation, it may be possible to petition that decision. Make sure to consult your doctor and specific insurance policy for advice on navigating this situation.

    Regardless of which type of care you receive, though, it’s important to remember that eating disorder treatment works. With the right kind of help and support, it’s possible to make a full recovery from these conditions and live a happier and healthier life.

    FAQs

    What is Inpatient Treatment for Eating Disorders Like?

    Inpatient treatment for eating disorders is the most intensive form of eating disorder care. It usually takes place at a hospital or specialized medical facility, where patients undergo 24-hour medical care and monitoring. Inpatient treatment focuses on immediate threats to someone’s life, including physical breakdowns and suicidal ideation, and often involves intensive or life-saving measures.

    What is Residential Treatment for Eating Disorders Like?

    Residential treatment for eating disorders is an intensive form of care where patients live full-time at a treatment facility. This type of care is more focused on long-term recovery, utilizing individual and group therapy sessions, medical monitoring, meal support, and nutritional counseling. Patients generally stay for one or several months, following strict daily schedules that include various treatments and recreational activities.

    1. Levels of Care. (n.d.) University of California San Diego. Accessed August 2024.
    2. Feeding Tubes for Severe Anorexia and ARFID. (2021, February 26). Acute Center for Eating Disorders & Severe Malnutrition. Accessed August 2024.
    3. Eating disorder treatment: Know your options. (n.d.) Mayo Clinic. Accessed August 2024.
    4. Van Huysse JL, Prohaska N, Miller C, Jary J, Sturza J, Etsell K, & Bravender T. (2023). Adolescent eating disorder treatment outcomes of an in-person partial hospital program versus a virtual intensive outpatient program. The International Journal of Eating Disorders; 56(1):192–202.

    Published September 11, 2024.