Intensive Outpatient Treatment for Bulimia: How It Works

Intensive outpatient programs (IOPs) are increasingly popular treatment options for patients with eating disorders, including those struggling with bulimia nervosa (BN).

These types of programs provide a level of care that falls between traditional outpatient therapy and a partial hospitalization program. Patients benefit from a more intensive treatment than they would receive in a standard outpatient setting while maintaining some level of autonomy in their daily lives and choices.

If you or a loved one are struggling with bulimia nervosa, you may benefit from the type of care available through an IOP. But there are some considerations when choosing the best IOP for you.

What Is an Intensive Outpatient Treatment Program?

An intensive outpatient program is a treatment option that allows patients to receive an intensive level of care while having the time and space to practice their new coping skills outside of a facility setting. During this phase of eating disorder recovery, a patient lives and sleeps at home while commuting to a treatment facility for care.

Even so, IOPs are considered “intensive” because of the amount of treatment hours that are required. Most IOPs take place at least for at least:1

• 6 hours per week for teens
• 9 hours per week for adults

Depending on the severity of the patient’s condition, this level of care can last anywhere from one to six months. Generally, someone will start participating in less intensive care as their eating disorder behaviors lessen in frequency and severity.

Overall, these programs are designed to help bulimia nervosa patients build healthy eating habits, address their triggers, and cope with underlying psychological issues that may be contributing to the eating disorder.

What Are IOPs Like?

An intensive outpatient program can involve any number of treatments, including:

• Group therapy sessions
• Individual therapy
• Nutritional counseling
• Medication management

Often, patients also participate in family therapy or attend support groups during this time to help with any eating disorder symptoms or related unhelpful thoughts and behaviors that aren’t being explicitly addressed through their treatment plans.1

Each patient’s particular path will be as individual as the patient. However, the main goal of an IOP is to provide a comprehensive care plan that helps sufferers with long-term recovery without being admitted to a hospital full-time.

Intensive Outpatient Programs vs. Outpatient Treatment

Despite having “outpatient” in the name, IOPs offer a different level of care from standard outpatient treatment.

Outpatient treatment is typically less intensive, with clients attending therapy sessions for just a few hours each week while maintaining their regular daily schedule. For example, many eating disorder patients following a standard outpatient treatment plan will have about 15-20 therapy sessions spread out over a 6-9 month period.2

On the other hand, IOPs consist of more structured therapy sessions that can last for several hours a day, several times per week. In some cases, intensive outpatient treatment may also be used as a stepping stone for eating disorder patients who are transitioning out of an inpatient program but could still benefit from intensive therapy.

The frequency and intensity of IOPs often make them more suitable for individuals with moderate to severe eating disorders who require more support than traditional outpatient treatment can provide. That said, conventional outpatient treatment may be the right fit for patients with less severe symptoms or who have already completed a more rigorous care method, such as inpatient treatment.

Ultimately, the choice between intensive outpatient programs and outpatient treatment depends on the patient’s individual needs and life circumstances.

Intensive Outpatient Programs vs. Partial Hospitalization Programs

A partial hospitalization program (PHP) is the next most intensive level of care after an IOP. While they share similarities, such as providing intensive therapy and medical support, there are also key differences.

PHPs are generally more intensive than IOPs, with a patient attending treatment for the majority of the day most days of the week. It’s the first step many patients take after completing an inpatient program.

Someone is usually considered a good candidate for a PHP if they are medically stable but still unable to function normally in regular day-to-day activities.3 Even if a patient is psychiatrically stable, they may need more frequent monitoring and medical attention than what is offered in an IOP.4

IOPs usually involve fewer treatment hours per week than PHPs, making them a more flexible option for patients who are ready to balance their eating disorder treatment with work, school, and other activities. Alternatively, a patient who is being treated in a PHP setting is more likely to be under constant supervision both at their treatment facility and at home.1

Who are Intensive Outpatient Programs Best for?

Intensive outpatient programs are designed to provide a lower level of care than inpatient treatment but with more structure and support than traditional outpatient therapy. As such, IOPs are ideal for patients who need a stronger, more in-depth support system but are also stable enough not to require regular supervision and medical attention.

The types of patients who benefit most from intensive outpatient programs tend to be those who:1

• Do not need detoxification
• Are not a danger to themselves or others
• Have a strong support system at home
• Are ready to continue attending work, school, or take on other responsibilities while undergoing treatment

Patients transitioning from inpatient to outpatient treatment are also good candidates for intensive outpatient programs, as this level of care provides a starting point for patients to continue getting support and treatment while slowly adjusting to a more autonomous lifestyle.

Overall, IOPs are a highly effective and flexible treatment option for patients suffering from bulimia nervosa and other eating disorders.

Benefits of an Intensive Outpatient Program?

Intensive outpatient programs can have a lot of benefits for eating disorder patients. Some of the major benefits of an IOP include:

• The ability to maintain daily activities while going through treatment
• Generally, more affordable programs
• A strong, supportive environment for recovery
• The chance to learn and practice healthy coping mechanisms in real-life situations

In addition to these benefits, intensive outpatient programs are often carried out with a team-based approach. This means the patient will have access to a therapist, dietitian, and other specialists who work diligently together to develop a personalized care plan. With such a thorough approach to treatment, the patient receives help addressing the physical, emotional, and mental aspects of their disorder.

Overall, IOPs can be an effective treatment option for eating disorder patients who need more support and structure than traditional outpatient therapy but also need the flexibility to attend to their daily responsibilities. These programs offer a supportive and collaborative environment that can help pave the way to long-term recovery.

Finding the best IOP Option for you

If you or someone you know is suffering from bulimia or another eating disorder, don’t hesitate to seek help.

Your primary care physician, therapist, or another trusted medical professional is great to talk to about the next best steps. These experts are generally well-versed in eating disorders and can point you in the direction of a helpful program or other treatment options.

A number of eating disorder hotlines also offer information and other resources about bulimia nervosa and other eating disorders, as well as recovery options. These services allow callers to remain anonymous while pointing them toward further help.

Regardless, finding help is the first step on the road to recovery, which can help you or your loved one overcome these unhelpful thoughts and behaviors and embrace a healthier and happier future.

References

1. Ditzell J. (2022, April 28). Intensive outpatient therapy: What it is, programs, and more. Medical News Today. Accessed May 2023.
2. Outpatient. (n.d.). UCSF Eating Disorders Program. Accessed May 2023.
3. Levels of Care. (n.d.). National Eating Disorders Association. Accessed May 2023.
4. Simpson CC, Towne TL, Karam AM, Donahue JM, Hadjeasgari CF, Rockwell R, & Kaye WH. (2021). Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program. Frontiers in Psychology; 12:667868.

Published on January 12th, 2024 on EatingDisorderHope.com