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Treatment for eating disorders
How eating disorders are treated, from team care and levels of care to family-based treatment, CBT-E, nutrition help, medicines and recovery.
Eating disorders can be treated, and many people recover.13 Treatment usually mixes talk therapy, regular eating with help from a dietitian, medical care, and, for some people, medicine. Support from family or close friends can make a big difference.1
Starting is often the hardest step. Many people feel shame or fear. In a large U.S. survey from 2001 to 2003, fewer than half of adults with an eating disorder had ever been treated for it.2 This page explains what care can look like, so the path feels less unknown. For the basics, see our overview of eating disorders.
Key points
- Care usually works best as a team: a medical doctor, a therapist, and a dietitian (a food and nutrition expert), with family or friends involved when it helps.1,4
- Family-based treatment is a first-line choice for teens with anorexia or bulimia. CBT (cognitive behavioral therapy) is a main choice for adults, especially for bulimia and binge-eating disorder.3,4
- Medicine has a smaller role. Fluoxetine is approved for bulimia and lisdexamfetamine for binge-eating disorder in adults. No medicine is approved for anorexia.1,7,8
- Some people need more than weekly visits, or a hospital stay. Fainting, chest pain, a seizure or confusion need emergency care.3,6
- Most people in a 22-year study recovered, and most who recovered stayed well. A setback does not mean treatment has failed.11
Who is on a treatment team?
Eating disorders affect the mind and the body, so care often has several parts. A good team might include:1,4
- A primary care doctor or other medical provider. They check your heart, blood tests and general health. Care for the body is part of treatment, not an extra.
- A therapist. This may be a psychologist, counselor, social worker or psychiatrist. They help with the thoughts, feelings and habits tied to food and body image.
- A dietitian. They help you rebuild steady, regular eating and a calmer relationship with food.
- Family or close supporters. Their role depends on age and need. They are central for teens and can help adults too.
A psychiatrist (a doctor who treats mental health conditions) may join if medicine is being considered, or if you also have depression, anxiety or another condition. These are common alongside eating disorders and can make them worse. See depression, anxiety and OCD.1
Your primary care provider is a good first stop. They can check your health and refer you to a mental health professional. You can also search at findtreatment.samhsa.gov.1 Our guide to finding a therapist can help.
What are the levels of care?
Not everyone needs the same amount of help. The right level depends on how safe your body is, how much the eating disorder takes over daily life, and whether you can get better with less support. A professional assessment decides this, and the level can go up or down as you change.5
| Level | What it looks like |
|---|---|
| Outpatient | You live at home and see your providers, often weekly. For people who are medically stable.5 |
| Intensive outpatient (IOP) | A few set sessions each week, for several hours each time. You can often keep working or going to school.5 |
| Partial hospitalization (PHP, or day treatment) | Most of the day, most days of the week, with therapy, nutrition help and supported meals. You sleep at home.5 |
| Residential | You live at the program with 24-hour care. For people who are medically stable but still struggling with eating disorder behaviors.5 |
| Inpatient or hospital | A 24-hour medical or psychiatric unit. For people whose health is in danger or who are not improving with less care.5,6 |
Many people start in the middle and step down as they improve. Others begin at home and move up if they are not getting better.
When is the hospital needed?
Doctors may advise a hospital stay for refusing to eat, fainting, a seizure, heart problems, dangerous blood salt (electrolyte) changes, dehydration, or when outpatient care is not working. It can also be needed if there is a risk of self-harm.3,6 The aim is to make the body safe first. Then the person moves to a lower level of care and continues therapy and nutrition support.6
Restarting regular eating after a long time of eating too little can be risky. The body can react badly, a problem called refeeding. Doctors watch for it with heart tests and blood tests, so it needs medical care.4,6 Read more on health effects and medical risks.
What therapies work?
See also our page on CBT. For teens, ask the team how parents will be involved. Family-based treatment is not about blame. Families can be a strong part of the solution.1,3
What role do medicines play?
Medicine is not the main treatment for most eating disorders. It is usually used together with therapy and nutrition care. Never start, stop or change a medicine on your own. Talk with your doctor or pharmacist before changing anything. This page does not give doses.
Bulimia nervosa
Fluoxetine Strong evidence A type of antidepressant (an SSRI). It is approved for bulimia in adults and teens and lowers binge-eating and purging behaviors. The FDA label says to watch for new or worse suicidal thoughts in young people on antidepressants.3,7
Binge-eating disorder
Lisdexamfetamine Moderate evidence A stimulant approved for adults with moderate to severe binge-eating disorder. It can reduce binge episodes.3,8 It is not a weight-loss drug. It carries a boxed warning about abuse and dependence, so doctors check this risk first.8 Generic versions are now approved.9
Anorexia nervosa. No medicine is FDA-approved to treat anorexia.1 SSRIs are often tried, but the evidence for them is weak.3 One large trial found a small benefit from olanzapine on appetite and weight gain.3 Limited research Medicine does not replace nutrition and therapy.
Safety note. Bupropion, an antidepressant, is not used for people with anorexia or bulimia because of the risk of seizures.3 Tell every doctor about your eating disorder before any new medicine is prescribed. Learn more about antidepressants.
Medicine can also treat depression or anxiety that come with an eating disorder.1
What is recovery like?
Recovery is not a straight line, and it takes time. Different people recover in different ways. Some feel better in months, and others need years of support.
A long study followed women with anorexia or bulimia for 22 years. About 6 in 10 with anorexia and about 7 in 10 with bulimia had recovered by the end. Most who had recovered stayed well. About 1 in 10 people with anorexia and 1 in 5 with bulimia lost their recovery after a time of being well.11 The study used a strict definition of recovery. These numbers come from one group of women, and your path may differ. The message is hopeful. Eating disorders are not a life sentence.
Relapse (a return of symptoms) can happen. It does not mean you failed or that treatment does not work. Tell your team early if old thoughts or habits return, during stress, illness, loss or big life changes. Getting help quickly makes a return easier to turn around.
After active treatment, many people keep seeing a therapist or dietitian from time to time, or join a support group.6 You may also like to write a safety plan that lists your warning signs and who to call.
In midlife and later life
Eating disorders can start or continue at any age, including after 50. Treatment follows the same ideas. Older adults may also need closer medical care, because of other health conditions and medicines. A weight or appetite change may have other causes, so a full check-up matters. See eating disorders in midlife and later life. Medicare may cover some mental health care. See what Medicare covers.
Questions to ask a provider
What level of care do you think is right for me, and why?
- What would tell us to move up or down?
- How will you check my heart and blood tests?
What type of therapy will we use?
- Do you use family-based treatment or CBT-E?
- How long does it usually take? How will we see progress?
Who else is on the team?
- Can you refer me to a dietitian?
- How will the team talk to each other and to my family?
Could medicine help?
- What is it for, and what are the side effects?
- How will it fit with my other medicines?
Keep reading in this section
- Eating disorders overview
- Signs of an eating disorder
- Types of eating disorders
- Causes and risk factors
- Health effects and medical risks
- Helping someone with an eating disorder
- Eating disorders in midlife and later life
When to get help
- Call 911 for fainting, chest pain, a very slow or uneven heartbeat, trouble breathing, a seizure, or sudden confusion.3,6
- Call or text 988 if you or someone you love is thinking about suicide or self-harm. It is free and open 24 hours a day.
- Call your doctor soon if you are worried about your eating, or if a loved one is. Early help matters.13 You do not have to be "sick enough" to ask for it.
- Call the helpline. The National Alliance for Eating Disorders runs a free helpline at (866) 662-1235. The Alliance lists weekday hours, 9 a.m. to 7 p.m. Eastern time, so check its website for current hours. It took over the former National Eating Disorders Association (NEDA) helpline, which closed in 2023. As of 2023, the old NEDA number forwarded to the Alliance line.12
If someone you love is struggling, see helping someone with an eating disorder and supporting someone in treatment. More help is on our help page.
Sources
- National Institute of Mental Health. Eating disorders: what you need to know. NIMH. NIMH
- National Institute of Mental Health. Eating disorders statistics. NIMH. NIMH
- Eating disorders in primary care: diagnosis and management. American Family Physician, 2021. AAFP
- Treating patients with eating disorders: guidelines from the American Psychiatric Association (practice guideline summary). American Family Physician, 2024. AAFP
- National Alliance for Eating Disorders. Types of eating disorder treatment: levels of care. The Alliance. Alliance
- National Alliance for Eating Disorders. What is inpatient eating disorder treatment? 5 things to know. The Alliance. Alliance
- U.S. Food and Drug Administration. Prozac (fluoxetine) prescribing information. DailyMed, National Library of Medicine. DailyMed
- U.S. Food and Drug Administration. Vyvanse (lisdexamfetamine dimesylate) prescribing information. FDA, 2017. FDA label
- U.S. Food and Drug Administration. FDA approves multiple generics of ADHD and BED treatment. FDA. FDA
- Fairburn CG, et al. Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry, 2009. UEA repository
- Eddy KT, et al. Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up. J Clin Psychiatry, 2017. J Clin Psychiatry
- National Alliance for Eating Disorders. Helpline acquisition and expanded services. The Alliance, 2023. Alliance
- National Institute of Mental Health. Eating disorders (health topic). NIMH. NIMH
Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.