Frequently Asked Questions
How long does it take to treat an eating disorder?
The length of time for treatment varies, depending on age and circumstances, but for most it is a long-term commitment. A common treatment schedule entails psychotherapy one to three times a week, and weekly sessions with the dietitian. Medical visits are more variable, depending on individual need. Most anorexia nervosa patients can expect to see the physician weekly at first. Bulimia nervosa patients with normal electrolytes start at every two to four weeks.
With clinical improvement, therapy and nutrition visits decrease gradually depending on the needs and progress of each patient. Medical visits will decrease to several times a year, or annually for some patients.
When one or both parents participate in treatment (i.e. attending weekly family sessions) eating disorder treatment generally progresses more quickly.
How will I know how my son/daughter is progressing?
If your child is an adolescent, we recommend that one or both parents come to at least every other medical visit, even if your teen is able to provide their own transportation. Parents generally do not participate in individual psychotherapy sessions, but the psychotherapist will speak with you by telephone or at the office in case of any concerns. For nutrition sessions, the dietitian will let you know how much parent involvement is needed.
Most patients who initiate comprehensive treatment with the physician, dietitian, and psychotherapist have a treatment team meeting scheduled in four to eight weeks. Treatment team and immediate family members will meet with the patient to discuss progress and future treatment goals. Often changes will be recommended at this meeting, for example, adding another modality such as family therapy or changing the frequency of visits.
Subsequent treatment team meetings are held as needed, generally every four to eight weeks. Meetings can also be used to discuss more complicated issues such as the need for a higher level of care or transition to college.
How do you decide whether a higher level of care is needed?
For some patients this will be evident at the initial evaluation and immediate residential or intensive outpatient treatment will be recommended. For outpatients, we generally use the following criteria: anorexia nervosa patients stop losing weight as a first step, and then begin to gain weight. Bulimia nervosa patients work on first reducing the frequency of bingeing and purging, and then eliminating these behaviors. Compulsive overeaters first stop gaining weight, and then begin to lose weight.
Patients who are unable to progress in outpatient treatment will be assisted in finding a program that is best suited to their situation.
What is the prognosis?
Over 70% of patients who begin treatment in adolescence improve or recover completely.
Our daughter has been working with a psychologist for the past six months. Do we have to switch to a psychologist in your team?
Not necessarily. Every person and situation is different. We will discuss the options with you at your initial consultation. In our experience, working within our team leads to more cohesive treatment, improving your success.
Do you see patients outside the adolescent/young adult age range?
We see teens and young adults as a treatment team; our group includes an adolescent medicine specialist, pediatric gastroenterologist, and a psychiatrist with advanced fellowship training in pediatric and adolescent psychiatry. (Patients outside this age range may be seen by a partial team if space permits, for example, a 40 year-old may be seen by the psychologist and dietitian, and use a different physician).