Inpatient Hospitalization

Do inpatient hospitalizations for eating disorders really work?


In the early 1990’s when I first entered the mental health field, I worked at Fair Oaks Hospital. They had an eating disorder program. The average length of stay for a patient with an eating disorder was 7-10 weeks. This past year in my practice, I have worked with 2 clients who have been hospitalized, both at Somerset Medical Center. The average length of stay for both of these women was 14-21 days. I feel both places offered excellent treatment. I do feel, however, that the shortened length of stay makes a difference in the treatment. Most patients that require hospitalization today have some type of medical complication from their eating disorder and once they are stabilized, they can go home. Years ago, once the patient was stabilized, they could stay and really get involved in the full program. It seems as though, insurance parameters make the stay shorter. I hope in the future policy makers and insurance companies become more familiar with eating disorders and their treatment.

Compulsive Eating

I have been asked many times by other mental health professionals as well as many clients what do I find is the most difficult eating disorder to treat and why?

I find people who have a compulsive overeating disorder the most difficult to treat. Let me define compulsive eating. Compulsive eating is characterized by periods of impulsive gorging or continuous eating. Usually there is no purging but there may be sporadic fasts or repetitive attempts at dieting. Body weight can vary from normal to mild, moderate or severe obesity. Many of the compulsive overeaters I have seen in my practice are struggling with obesity issues. I think this makes their illnesses more complicated and perhaps more difficult to treat.

Compulsive overeaters usually eat when they are depressed, anxious and or frustrated. These people struggle with body image issues. People, who compulsively eat similar to other eating disorders, struggle with low self-esteem, feelings of inadequacy, self hatred. Often times these feelings are at the core of who they are—it is a challenge to change these ideas. For example, when the person overeats, they will often report to me that they call themselves names, they retreat to bed for feeling shameful and to turn that around feels insurmountable to them.

Additionally, many of these people report that their binge eating began when they were children. This is often not the case with anorexia and or bulimia. I feel this also makes recovery more complicated.

An important part of treatment is to help people learn to like themselves because only then can they begin to nurture their minds and bodies and hence, the compulsive eating behavior improves. One thing I suggest in treatment with these clients is an exercise which seems so simple but becomes very difficult to sustain. I ask them to pay conscious attention to the amount of times they degrade themselves in the course of a day. Then I help them to recognize when the thoughts come and recommend they make a very specific effort to stop the thoughts and replace them with positive affirmations which we create together. And, I promise them if they commit to this and can do this long term they will begin to improve their self –esteem. I have seen this happen many times. It is the beginning of recovery.

Recovery from any eating disorder is difficult and takes tremendous commitment but as I always share it is possible. If you are struggling with these issues—remain hopeful and seek professional help and guidance.