Eating Disorder Treatment: The Least Restrictive Setting

Research on eating disorders consistently highlights that “treatment should be offered in the setting that is least restrictive and best suited to the individual’s needs and preferences.”[i]

The outpatient setting (treatment in one’s real-life environment) is the least restrictive treatment setting and the best course for the majority of patients.  More intensive, highly controlled settings are necessary primarily if there are immediate medical complications or co-occurring issues like suicidality that require a high level of oversight and intervention.

Treating in a “real life” setting makes sense for a number of reasons:
  1. The Leading Eating Disorder Treatments Are Designed for Outpatient

The gold standard treatments for eating disorders are designed for outpatient application.  They can be adapted somewhat for Day Programs or Residential settings, but they were designed for and tested in the outpatient practice setting.

  1. Work, School, Family Obligations

For most people, participation in work, school or family/social life is an important factor and “taking a break” from these responsibilities for treatment may be impossible.  Outpatient treatment reduces disruption dramatically; in outpatient, you’re encouraged to engage, particularly in activities and pursuits that enrich your life, breed a sense of efficacy and boost self-esteem.

  1. Opportunity to Address Stressors Head On

While it’s not easy, working through treatment in the context of daily life challenges allows you to fully address them – with support – and gives you the opportunity to practice new, more effective ways of coping.

  1. Cost

Outpatient treatment is the most affordable level of care.  It is said to be approximately 10% of the cost of inpatient.[ii]  Since most of us rely on insurance for major medical expenses, the “higher levels of care” like Residential, Partial Hospital and Day Treatment, may be out of the question; insurance companies are becoming increasingly reticent to cover these higher levels care and if they do, the treatment stays are shorter than ever. Unless there is immediate medical risk, most managed care companies require that patients receive an outpatient trial of treatment first.

Getting Help

At Columbus Park, we use short-term, time-limited outpatient treatments that are effective even for the more severe eating disorders.  We treat people while encouraging engagement in other important life pursuits like school, work, social events…. We structure our programming with flexibility so that our patients can maintain some normalcy as they work through the recovery process.

Columbus Park outpatient center for eating disorders provides the least restrictive setting for ED care.  The first step is a thorough assessment.  Contact us to get started.

Alternatives to Support Recovery in the Least Restrictive Setting Possible

Unfortunately, access to specialized care for many is limited.  Even in highly populated, sophisticated cities, finding the right treatment can be difficult.  For those readers who identify with this challenge, my3square, Columbus Park’s “sister” program, may be an ideal resource.  My3square telehealth application was designed to reach eating disorder sufferers even in the most remote locations, providing expert videoconference coaching around mealtime – up to 3 meals per day, 7 days per week. Participants do need to be in treatment – with any licensed Therapist or Registered Dietician – but my3square can supplement treatment and propel the process forward by providing targeted ED-centered coaching and skills.  Either one-on-one or in groups, participants can join videoconference meal sessions to gain support, skills and community around mealtime.  The best part is that you don’t even have to leave your home or office to benefit from my3square meal coaching; we come to you via videoconference. All you need is a smartphone or internet connection.

In some cases, my3square can be used to strategically to avoid having to elevate treatment to a higher level of care.  In other words, my3square support service can make it possible to progress through recovery in an unrestricted setting.  Learn more here.


[i] Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, Touyz S, Ward W. Australian & New Zealand Journal of Psychiatry 2014, Vol. 48 (11) 977–1008.

[ii] Katzman DK, Golden NH, Neumark-Sztainer D, et al. (2000) From prevention to prognosis: Clinical research update on adolescent eating disorders. Pediatric Research 47: 709–712.