I get this question a lot when new patients come to our clinic. “How long will I have to be in treatment?” Honestly, I don’t have a great answer for them other than, “As long as it takes to get you completely over your eating disorder.”
When I laid out the core principles for The Body Image Therapy Center (TBITC), I made sure to include the following: If we are only interested in harm reduction, then we are not meeting our purpose. Our metric MUST be to see clients cease ALL self-destructive behaviors and sustain that recovery for at least one year.
Two thirds of those who seek treatment do fully recover. Many struggle off and on with ED behaviors and thinking the rest of their lives. Sadly, not an insignificant number never recover. This is, after all, the deadliest mental health diagnosis there is.
When patients come into our Intensive Outpatient Program (IOP), our intention is to keep them at this higher level of care until their eating disorder behaviors are absent for four weeks before we step them down to standard outpatient therapy. Why? Because if we don’t succeed in eliminating the behavior, it’s less likely they will get to the root cause of what drove them to the eating disorder to begin with. That’s easier said than done of course. Many of our patients have to devote 12-16 hours of their week outside of school and work to their recovery, and do so for up to 16 weeks or more. But that’s the reality of what it takes. And IOP may not be enough. Patients get stuck, and we have to move them up to a higher level of care to get them unstuck at times.
In the end, it takes years for most to completely move beyond lapses into old ED behavior and thought patterns for good. For many with Binge Eating Disorder (BED) it can take even longer than those with anorexia and bulimia for any number of reasons but most especially due to weight stigma, fat prejudice, and diet mentality of those who live in a larger body as so many with BED do.
That’s why I don’t believe in letting patients go without fully moving beyond the self-destructive behaviors of their eating disorder and associated forms for self-harm like cutting, isolating, and the like. Many of us at TBITC have been through the wars of ED and come out the other side. We know full recovery is possible. Give recovery everything you’ve got as long as you’ve got it. “As long as it takes.”
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 443-602-6515 or email firstname.lastname@example.org.