Guide to Choosing the Best Online Therapy for Eating Disorders
Is Online Therapy for Eating Disorders Worth It?
Online therapy for eating disorders can be just as effective as in-person therapy. Research has shown that virtual intensive outpatient (IOP) treatment has comparable outcomes to in-person IOP, and that online administration of family-based treatment was effective in treating eating disorders in youth.
Accessibility is another key factor. “Online eating disorder therapy removes a lot of the barriers to care that many people struggling with eating disorders experience,” explains Owens. Online care eliminates travel and wait times, offers wider access to providers, and allows people to recover from the comfort of their homes. These services are typically less expensive than in-person options, too, as many telehealth companies were founded specifically with affordability in mind. Plus, the convenience of online therapy is a strong motivator. “Someone who is otherwise ambivalent about seeking care for an eating disorder might be more likely to give it a try,” says Owens.
However, online therapy isn’t appropriate for everyone dealing with an eating disorder, Dr. Marschall cautions. “Some treatment protocols require medical assessments that have to be done in person,” she says, “like those who are underweight or have a possible cardiac issue related to their disorder.” For that reason, many platforms that offer IOPs or other eating-disorder-specific treatments perform a medical assessment to confirm you are a good candidate for a virtual program
What Are the Most Successful Treatments for Eating Disorders?
Eating disorders are complex; thus, treatment can often include a combination of therapy, education, and medical monitoring. In some cases, medications may also be prescribed, but therapy is usually the first line of defense.
Family-based treatment (FBT) is currently considered the gold standard for eating disorder treatment in children, teens, and young adults whereas cognitive behavioral therapy (CBT) is often recommended when treating adults.
With FBT, every family member is involved in treatment. Instead of working to identify the underlying cause(s) of the eating disorder, FBT begins by focusing on weight restoration and re-establishing healthy eating patterns. For adolescents with anorexia and bulimia, FBT is the most well-established form of treatment.
CBT, on the other hand, is a time-tested psychotherapy approach that aims to teach people how to identify negative or destructive thought patterns and replace them with healthier ones. It’s been shown to be effective in addressing a wide range of mental health concerns, including depression, anxiety, substance use disorders, and eating disorders. With adults, CBT has been found to be the most effective form of treatment, particularly for adults with bulimia and binge eating disorder.
Interpersonal therapy (IPT) has also demonstrated efficacy in treating adults with bulimia and binge eating disorder. This is a form of talk therapy that focuses on interpersonal stressors that may exacerbate eating disorder symptoms.
Comparing Online Therapy for Eating Disorders
There are a variety of factors to consider when choosing which online therapy is best for you. These include:
Price: With many companies, you won’t know the cost of treatment until you sign up or at least complete an initial consultation. Sometimes you won’t even know if the company takes your insurance. Know your budget beforehand, and whether you’re planning on using insurance or not.
Specialties: If you already know which type of eating disorder you have, that could make the search for a specialist provider easier. If you aren’t sure of your diagnosis but believe you have a problem, a more generalized program or therapy platform might be a better bet.
Type of therapy offered: Choose a company that uses the type of therapy you’re interested in exploring, if you have a preference, or one that is aimed at your age group. Options often include CBT, family-based treatment, and individual and group psychotherapy.
Breadth of care team: Perhaps you’re looking for a care team that includes a psychotherapist, nurse, dietitian, and other healthcare support people, or perhaps you just want to try talk therapy.
Scheduling: If you need flexible scheduling options, such as evening or weekend appointments, find a company that offers this.
Platform and interface options: Decide how you’d like to access care, whether it be via a computer, tablet, or phone. You may prefer the ability to do everything from your phone in an app portal.
Financial assistance or free consultations: Does the company offer a free consultation? Is that something that’s important to you? For patients paying out-of-pocket, does the company provide sliding scale options or financial aid?
Frequently Asked Questions
Can You Have an Eating Disorder Without Being Underweight?
Yes, people with atypical anorexia are not underweight, but rather within or above what’s considered the normal weight range. Eating disorders are prevalent among larger-bodied individuals—it’s estimated that more than half of people with an eating disorder are not underweight. But due to the weight stigma surrounding eating disorders, these cases often go unreported or misdiagnosed.
Can an Eating Disorder Be Fully Cured?
Yes, eating disorders can be fully overcome, but “cured” isn’t a word you’ll find mentioned very often in eating disorder treatment. Mostly you will hear about people being “in recovery” from an eating disorder. It often takes time to fully recover from an eating disorder, but it can be done.
What Is the Success Rate for Online Therapy Treating Eating Disorders?
Success rates can vary depending on a number of factors, but research suggests that online treatment can be extremely effective when it comes to eating disorders. In one study, adults who used a virtual IOP showed meaningful improvements in self-reported eating disorder symptoms, depression, self-esteem, and quality of life.
What Is the Average Time to Overcome an Eating Disorder?
The amount of time it takes depends on the person, the type of eating disorder, and the severity. “Often, eating disorders require long-term therapy and follow-up that can take years,” Dr. Marschall says. “EDs have the highest fatality rate of any mental illness, so it is important that individuals receive appropriate care for as long as they need.”
Recovery is a process—people go through several stages, moving from denial to acceptance to being ready to seek help, and everyone will move through them at different speeds.
Methodology
When assessing the best online therapy for eating disorders, we analyzed 18 companies. The factors considered included price, types of therapy, program effectiveness, professionals including the care team, insurance acceptance, user experience, accessibility, and any specializations.
