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Learn more about the results we get at Within

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Intensive outpatient treatment for eating disorders

While all eating disorders are serious mental health conditions, symptoms span a spectrum of severity. To cater to this range of manifestations, eating disorder treatment is also offered along a spectrum, with different levels of care meant to help people at different stages of recovery.

Intensive outpatient eating disorder treatment is one of these levels of care. People participating in intensive outpatient programs (IOPs) live and sleep at home and commute to eating disorder treatment several times a week, for a few hours per session.2

IOP eating disorder treatment can happen toward the beginning of someone's recovery journey, if standard outpatient treatment is not enough help, or toward the end, if someone is stepping down from more intensive types of care. Regardless, it allows patients to continue receiving care, structure, and support, while giving them more time to participate in other social responsibilities.

7
 minute read
Last updated on 
September 20, 2023
February 5, 2024
Treatment for eating disorders
In this article

How are eating disorders treated with intensive outpatient programs?

During IOP eating disorder treatment, patients meet with a multidisciplinary team of experts to help with different aspects of their ongoing eating disorder recovery. If a patient is stepping down from more intensive types of care, they may be able to keep their same treatment team, depending on the program.

Learn about Within's fully remote treatment program for eating disorders.

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During IOP eating disorder treatment, patients meet with a multidisciplinary team of experts to help with different aspects of their ongoing eating disorder recovery. If a patient is stepping down from more intensive types of care, they may be able to keep their same treatment team, depending on the program.

A typical eating disorder intensive outpatient program may include:2

IOPs for eating disorders may also include other types of care, such as meetings with a psychiatrist, medical doctor, or a medical specialist.

Treatment programs and therapeutic approaches will vary between facilities. The type of therapy provided depends on what is the best fit for the individual. A tailored program may focus on dialectical behavior therapy (DBT), cognitive behavior therapy (CBT), family-based therapy (FBT), a combination of these, or other types of therapy.

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What to expect in intensive outpatient eating disorder treatment? 

Most patients in higher levels of care, including intensive outpatient eating disorder programs, follow treatment plans that are designed for their specific needs and history, so each IOP schedule may look a little different. But generally, the programs run several days a week, for around three hours per day.2

During that time, patients may have regular meetings with their therapist and/or nutritionist, receiving nutrition education and attending individual therapy sessions, and sometimes group therapy meetings. Most programs also include some monitored meals or snacks, and some feature off-site trips, to help patients practice different skills outside of a treatment setting.2

The duration of IOP eating disorder programs depends on the needs and progress of the individual. But following discharge, many patients are able to attend aftercare group sessions, sometimes with other participants of the program. These are usually attended in addition to a regular outpatient eating disorder program, which generally consists of a meeting with a therapist once or twice per week.8

Who should attend an outpatient eating disorder program?

While IOP for eating disorders is considered a higher level of care, patients at this stage are generally able to function relatively well outside of eating disorder treatment facilities.1,9 Usually, patients attending an IOP:9

  • Can handle the lower-level structure of care provided by an IOP
  • Have their eating disorder symptoms mostly under control
  • Are medically stable/have no medical complications that need regular monitoring

Outpatient eating disorder treatment offers patients more support than they would receive from standard outpatient treatment, but aren't as time consuming as day treatment programs, like a partial hospitalization program (PHP).

This type of schedule makes an eating disorder intensive outpatient program ideal for patients who:2,9

  • Are transitioning between levels of care, whether they're stepping their care up or down
  • Need or want more support on their recovery journey
  • Are still occasionally experiencing triggers or relapses
  • Are lacking a strong support system at home
attend IOP graphic

Benefits of IOP eating disorder programs

Reintegration after residential treatment

An eating disorder IOP provides a middle ground between residential treatment or partial hospitalization and outpatient treatment. This can help patients more smoothly transition back into a more regular schedule, and start slowly integrating their recovery with other social responsibilities, like work and school.

Maintaining new skills

Since someone in an eating disorder intensive outpatient program lives at home while attending treatment, they can start using and practicing the skills they learn at therapy right away. This can help them better integrate these skills into their lives and maintain these approaches.3

Engagement in day-to-day life

The hybrid schedule of intensive outpatient eating disorder treatment allows people to start reintegrating obligations and activities back into their lives, which can help them engage more in their home environment and normalize their experiences.

Lower cost

In many cases, intensive outpatient eating disorder programs are much less costly than inpatient and residential treatment, or even intensive day programs like PHPs. This can make treatment more accessible to some, or make insurance companies more likely to cover the treatment.10

Efficacy of intensive outpatient eating disorder treatment

The use of IOP eating disorder programs has been found to demonstrate significant improvements in eating disorder pathology, including disordered eating symptoms and those affecting a patient's mental health.

When following up an intensive day program with an IOP, more than 70% of patients in one retrospective review were judged to have good or intermediate progress at the time of discharge. Particular improvements were made in weight gain, motivation to recover, eating disorder symptomatology, comorbid symptomatology, and quality of life.5

IOP progress rate graphic

Specialized eating disorder outpatient treatment was also found to help improve not just eating habits but body attitudes in one study following groups undergoing outpatient anorexia treatment and outpatient bulimia treatment.4

Furthermore, certain therapies commonly practiced in eating disorder intensive outpatient programs—particularly, CBT and a specialized type of that therapy—were found to lead to long-term results in some cases. One study found underweight eating disorder patients who completed these CBT therapiesin IOP treatment not only achieved weight gain, improvement of eating disorder symptoms, and better general psychopathology by the end of treatment, but maintained most of these improvements at a six-month follow up.6

IOP for eating disorders at Within Health

At Within Health, we offer a new virtual treatment model for eating disorders that exists between PHP and IOP levels of care.

Usually once people leave an IOP program, they will look to transition home, where the environment may be far less monitored and conducive to healing than the clinical setting. With our treatment model, clinicians stay with our patients every step of the way, treating people with eating disorders in their home environments, or wherever is comfortable for them.

Our clinical care team can provide up to twelve hours of care for each patient, which includes time spent with them during meal preparation, meals, and movement activities. Call our team now to learn about how to get started, or for more information on our treatment models.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Anderson, L., Reilly, E., Berner, L., et. al. (2017). Treating Eating Disorders at Higher Levels of Care: Overview and Challenges. Current Psychiatry Reports, 19, 48. 
  2. Milco, A. (2022). Finding The Right Treatment for Your Eating Disorder. National Eating Disorders Association. Accessed September 2023. 
  3. Intensive outpatient treatment. (2019). Beat Eating Disorders. Accessed August 2023.
  4. Cecile C. Exterkate, Patricia F. Vriesendorp, Cor A.J. de Jong. (2009). Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment, Eating Behaviors, 10(1), 16-21.
  5. Simic, M, Stewart, CS, Eisler, I, et al. (2018). Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder. International Journal of Eating Disorders, 51, 1261– 1269.
  6. Dalle Grave, R., Pasqualoni, E. & Calugi, S. (2008). Intensive Outpatient Cognitive Behaviour Therapy for Eating Disorder. Psihologijske teme, 17(2), 313-327.
  7. Eating Disorders Intensive Outpatient Program (EDIOP). Kaiser Permanente. Accessed August 2023.

FAQs

How long does intensive outpatient treatment last?

The length of an eating disorder outpatient treatment program depends on a number of details, including specifics about the patient's history, need, and progress. The structure of the program also comes into play.

Some IOPs for eating disorders can last up to 16 weeks, while others take place for longer or shorter periods of time.7

How many hours is IOP treatment?

Again, the exact schedule of an intensive outpatient eating disorder program varies on a case-by-case basis. However, many programs take place several days a week, for around three hours per day.2

What is outpatient eating disorder treatment like?

Outpatient eating disorder treatment is the lowest level of eating disorder care. It usually involves one or two meetings with a therapist or nutritionist every week, where patients discuss recovery goals, continue to work on new coping skills, and monitor for triggers or backslides.

Intensive outpatient programs for eating disorders are, as their name suggests, slightly more intensive. These programs take place several days a week and consist of individual therapy sessions, nutritional counseling, and usually group therapy and/or meal monitoring.

Do I need intensive outpatient treatment?

If you're asking yourself this question, it may be a sign that you need eating disorder treatment.

Intensive outpatient programs for eating disorders are an early step people can take to address concerning thoughts or behaviors they may be having around food, eating, and body image.

If you're struggling with these types of negative thoughts and/or behaviors, you should speak to your primary care physician, therapist, or another trusted medical professional about your concerns, and determine your best next steps.

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Further reading

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