Thoughts about the Changing Face of Eating Disorder Treatment

Starting the new year, I have had broader thoughts about the eating disorder treatment field and growing industry rather than on the individual level.

The trend of venture capital-backed treatment companies expanding throughout the country now dominates the industry. Virtual treatment programs, a new option in the years before the pandemic, are exploding and even luring people who have long been in private practice. Psychology Today, the easiest resource to find treatment, lists many clinicians who indicate that eating disorders are part of their treatment expertise, but there is no license or coursework that exists to prove this specialty. 

The result is that the growth in treatment options continues to veer away from medical, research proven treatment towards capitalism and marketing. 

Overall, there are two ways to look at the broadened access to eating disorder treatment. On the one hand, the increased incidence of eating disorders during the pandemic has led to a much higher need for treatment, more than private practice providers could handle. On the other hand, these new ventures are often run by people with limited experience treating people with eating disorders. The lack of any clear standard of care enables the various new treatment options to operate without any real oversight or regulation. 

I go back and forth between concern about the overall quality of care and the need for access. It’s easy to err on the side of quality and criticize these new ventures, but in the end I think that is shortsighted and a backwards way to approach a field that does not stop changing and growing. 

When I compare the treatment options in the US to barriers patients of mine have faced all through Europe, I quickly conclude that it’s better to have imperfect options than none at all. Patients who sought help in their home countries originally found there was no help and they had to manage on their own. Living in the US now, they unanimously prefer some options to none.

It’s also critical to realize that the large majority of the new surge in eating disorders stems from the social isolation and fears driven by the pandemic. These newer cases will, for the most part, be less complicated simply because eating disorders of shorter duration are usually easier to treat. The longer the eating disorder exists, the more hardened it is in someone’s life. So online programs or the treatment options run by less experienced clinicians can be very effective for the majority of these cases. 

Perhaps that is the model of the future. Early or less severe cases of eating disorders can be treated in these broader programs and the more challenging or longer lasting cases can see individual teams in private practice.

No treatment model will be perfect. As long as we live in a world of diet culture, glorified thinness, a powerful food industry and the bombardment of body images on social media, the incidence of eating disorders will remain high. If this new model offers treatment to the largest number of people, that has to be a positive thing.