Why I turned down inpatient eating disorder treatment
When I was diagnosed with an eating disorder, my mind naturally rushed to the worst case scenarios: visions of my body strapped to a hospital bed, held down by leather restraints, being force-fed the world’s fattiest foods in an effort to make me gain weight as quickly as possible. Simply, the stuff of my eating disorder’s nightmares.
I remembered after-school-special films we watched in high school sociology and health classes, ones that depicted eating disorders as hospital-bound ailments that warranted long-term stays at facilities hundreds of miles away from home. “Retreats” that would feature anything from feeding tubes to support group sessions to equine therapy. And on top of all of this fear-mongering imagery sat the most terrifying concept: financial ruin.
“Does this mean I need to go to a treatment center?” I asked my first-ever ED-trained therapist through glossy tear-filled eyes.
“Not necessarily,” she replied gently. “We can work on building a treatment team, first. Let’s see how it goes.”
So we did.
Going to an inpatient facility was too much for my newly diagnosed and underfed brain to comprehend. So I started (and stayed) in a place that worked best for me at that time in my life: outpatient.
Why did I choose (and stay with) outpatient treatment only? Here are a few reasons.
*Please note that the needs of people with eating disorders vary greatly. Not everyone benefits from the same treatment methods. This post is about my experience only and should in no way inform what you need and/or how you choose to recover. Please consult a medical professional to discuss your options.
1. I diminished the severity of my disorder
Unless we were missing limbs or coughing up an organ, my mom raised my sisters and me to stick with our commitments, even through sore throats and persistent coughs. But what about mental sickness?
What I knew until that point in my life was that mental sickness wasn’t always visible to the naked eye. It was the type you couldn’t see or hear, but it was felt. Growing up, I was often told that even physical disturbances like stomach aches were “all in my head,” which led me to minimalize a lot of what I thought and felt. As a result, my anxiety and depression remained trapped in a place of shame.
It wouldn’t be a stretch to see this type of thinking as a contributor to my decision to stay outside the treatment center walls.
2. That job thing
I received my ED diagnosis at age 21, just a few months after I’d started my very first “grown-up” job as an editor at an oncology nonprofit. How was I supposed to sit down with my new boss and tell her I would need a few months away from work to treat something I wasn’t even sure was that serious? Once again, I minimalized my situation and decided I would power through—to work and try to recover at the same time unless/until I was no longer able.
Plus, I had rent to pay, utilities, car insurance—I couldn’t just abandon my life but remain stuck to these financial obligations. Which brings me to my next reason…
3. …that cost thing
My new-grad, new-job, new-adult self had nearly no savings for anything resembling an emergency, which means I definitely didn’t have the means to take myself on a no-expenses paid trip to a treatment center. I had already stepped outside my insurance network in my search for a therapist who actually understood eating disorders, which was a major financial setback in and of itself. So far, I had learned that both inpatient and outpatient were costly options, but “out” was slightly less expensive.
My solution: ‘Intensive’ outpatient
With the above taken into consideration, I allowed my therapist to build for me an “intensive” outpatient treatment team, consisting of a:
therapist specializing in eating disorders
nutritionist
psychiatrist
primary care physician
Three out of four of these providers were not covered under my health insurance plan so I had to pay for their visits with cash, each of which cost between $100 and $200.
These fees weren’t easy for me to pay, but I could make it work. It was hard, however, to think about the countless others who were brave enough to attempt recovery, only to find out it was out of their reach financially. I knew I was privileged, and even though I didn’t know how long I would be able to pay for these services, I could at least manage for a few months.
How to know what’s right for your eating disorder recovery
All recovery journeys are different. Some people need more care but don’t think they do. Some can get by with outpatient. Some may have other commitments to family, careers, etc. they can’t abandon for long stays, while others can’t even afford in-network copays for occasional therapy.
If you’re just starting to consider your options for treatment, it’s important to keep the following in mind.
1. Seek advice from a medical professional you trust
Use resources like PsychologyToday.com to find a professional healthcare provider who specializes in eating disorders and (hopefully) accepts your insurance plan (if applicable). Based on your initial consultation with this provider, you may walk away with a better idea of your options or it may take a few sessions (or a few therapists) to figure out what you really need.
When you first meet with this professional, trust your instincts—if something doesn’t feel right, listen to that feeling. But also know that your eating disorder will likely be loudly protesting any action you take that goes against what it wants.
The best way to uncover what’s best for your recovery is to be as honest as you can with what you share. The more information the provider has, the more able they’ll be to help guide you in the right direction.
2. Don’t be afraid to disobey your eating disorder
As mentioned, your eating disorder will probably be ready to contradict every notion of recovery presented to you. It can be hard to differentiate between your own voice and that of your eating disorder, but this is an excellent practice to hone in the early stages of your recovery. You’ll be doing a lot of voice differentiation throughout your recovery, so starting early will serve you well.
As your eating disorder gets louder, it means you’re doing the right thing for your recovery. If the volume suddenly increases, keep going.
3. Asking for help is not a weakness
Eating disorders are isolating diseases. Your disorder may be working hard to convince you that no one else understands what you’re going through, so sharing your struggles is a futile endeavor. But the truth is, you’re not alone. And asking for help is the first step in driving that voice out and making room for your own voice to reclaim its territory.
I won’t end this post without acknowledging that all of this is scary—the idea of getting help, being vulnerable with a stranger, and preparing for a possible financial hit all mean you’re on the cusp of change.
Eating disorders work hard to keep us comfortable, and stepping beyond this boundary is nothing short of challenging. It requires courage, commitment, and consistency. But as sometime who on the other side, I can tell you with complete confidence that it’s worth it. It’s worth every dollar, every setback, every moment of crushing debilitation when you think recovery just isn’t for you.
I promise you, it is.
Pause & Prompt
What scares me most about recovery…
