The Paradox of Having Too Many Treatment Programs

Ten years ago, I was still writing about the lack of treatment programs available and how damaging this void was for people with eating disorders. Now, the opposite is true. There are so many programs, it’s hard to keep track.

No longer are people languishing at home desperate for more help. The broader issue now is that there are so many spots available in these programs that treatment is an easy decision for an outpatient provider or patient to choose.

A clinician needs to assess the pros and cons for each person to go into residential treatment. When someone is struggling and battling the internal struggle with the eating disorder thoughts, a program is not always the best option. Treatment or not, each person who is in recovery will have long periods of battling these thoughts and trying to move forward. Every moment of struggle doesn’t merit a treatment program.

Working with someone through the recovery process means tolerating the difficulty of progress and struggle. Of course, the patient bears the burden, but clinicians also need to tolerate difficult periods and allow the person their own struggle. Jumping to treatment ultimately shows a lack of trust and confidence, not always a sign of caring.

For some people, programs don’t really help. The outcome might be temporary improvement in medical symptoms but no change in the psychological part of the eating disorder. It’s just as important to realize that some people need outpatient treatment even while they struggle because that’s the way they can get better. The alternative of available programs doesn’t mean residential treatment is the right answer for everyone.

The explosion of programs has greatly improved access to care which was a significant barrier to recovery in the past. Clinicians who treat people with eating disorders are thankful for the change. Now, the provider also needs to weigh when treatment is appropriate and be sure to consider what is best for each person.

Relying on a program when things get hard in therapy isn’t always right either. Recovery is hard, looks different for everyone. The best definition I have for recovery is being able to live a life not dominated by the eating disorder.

Recovery is not the promised land of happiness. It means living your life with minimal impact of the eating disorder. Treatment is a part of the process but not a panacea.