Understanding the Different Levels of Eating Disorder Care
If you or someone you love is navigating an eating disorder, one of the most confusing parts can be understanding what kind of support is needed, and when. Many people assume eating disorder treatment is either “therapy” or “hospital,” but in reality there’s a spectrum of care levels, each designed to meet people where they’re at medically, psychologically, and practically.
I’ve been fortunate to work alongside highly skilled multidisciplinary teams across several levels of eating disorder care, and I continue to hold deep respect for the expertise and dedication required in each setting. I’ve seen firsthand how valuable each level of care can be. This blog is intended to give a broad, non-specific overview of those levels of care, how they fit together, and why stepping up (or down) in care is not a failure, but often a sign of responsive, ethical treatment.
Eating Disorder Care Exists on a Continuum
Eating disorders affect both mind and body. Because of this, treatment needs to flex depending on factors such as:
Medical stability
Nutritional status
Frequency and severity of eating disorder behaviours
Psychological risk (e.g., suicidality, compulsivity, rigidity)
Ability to function day-to-day (work, school, caregiving)
Level of support available outside of treatment
No single level of care is “better” than another. Instead, they each serve different purposes, and many people move between levels over the course of recovery.
Outpatient Care
What it is: Outpatient treatment typically involves seeing a clinician (or team) while continuing to live at home and maintain aspects of daily life such as work, study, or parenting.
Support may include:
Individual therapy
Dietetic support
Medical monitoring
Group therapy
Who it’s for: Outpatient care can be appropriate when someone is:
Medically stable
Able to eat regularly (even if with distress)
Not engaging in high-risk behaviours that require close monitoring
Able to use support between sessions
Why it matters: Outpatient treatment allows recovery to happen in real life. Skills are practised in real time in real environments, which can be incredibly powerful. For many people, this is where long-term recovery work happens, either as a starting point, or after stepping down from more intensive care.
Day Programmes/Intensive Outpatient Programmes
What they are: Day programmes (sometimes called partial hospitalisation or intensive outpatient programmes) sit between outpatient and inpatient care. People attend treatment for multiple hours per day, multiple days per week, but return home in the evenings.
These programmes often include:
Supported meals and snacks
Group-based therapy
Individual sessions
Medical oversight
Who they’re for: This level of care can be helpful when:
Outpatient support isn’t quite enough
Eating disorder behaviours are escalating
More meal support is needed
Structure is required to interrupt entrenched patterns
Why they matter: Day programmes offer containment and intensity without full removal from daily life. They can be a powerful step-up to prevent hospitalisation, or a step-down from inpatient care to support transition back into the community.
Residential Treatment
What it is: Residential treatment involves living on-site in a specialised eating disorder facility for a period of time. Treatment is structured and immersive, with 24-hour support.
Who it’s for: Residential care may be indicated when:
Eating disorder behaviours are severe and persistent
There is significant psychological risk
The home environment is not conducive to recovery
Previous levels of care have not been sufficient
Why it matters: Residential care allows for deep therapeutic work in an environment designed to reduce eating disorder reinforcement. For some, it creates the breathing space needed to stabilise, restore nutrition, and begin recovery work that simply isn’t possible in less intensive settings.
Inpatient/Hospital Care
What it is: Inpatient care typically takes place in a medical or psychiatric hospital setting and is primarily focused on medical stabilisation and safety.
Who it’s for: Hospitalisation is necessary when someone is:
Medically unstable
At acute risk to themselves
Unable to maintain basic nutritional or physical safety
Why it matters: Hospital care can be life-saving. While it is not designed to “cure” an eating disorder, it provides critical stabilisation so that recovery-focused treatment can continue afterward. Inpatient teams often manage complex medical and psychological risk simultaneously, and their work is highly specialised and intensive.
Stepping Up or Down in Care Is Not Failure
One of the most important messages I want to emphasise is this: Needing a higher level of care does not mean you’ve failed treatment; it means treatment is responding appropriately to your needs.
Similarly, stepping down in care isn’t about being “done” or no longer needing support, it’s about consolidating gains and learning how to sustain recovery outside of structured environments.
A Note on Access and Reality
In an ideal world, people would move fluidly between levels of care based solely on clinical need. In reality, access to eating disorder services (particularly specialised programmes) can be limited by geography, funding, waitlists, and eligibility criteria. Clinicians are often making careful, ethically complex decisions within systems that are under significant pressure; a reality that exists worldwide.
It’s also important to name something that often goes unspoken: the eating disorder mindset can become fixated on levels of care as a measure of “deservingness.” People may find themselves thinking that needing more intensive care means they are finally “sick enough” to deserve help, or conversely, that not qualifying for a higher level of care means their suffering isn’t valid.
This way of thinking is deeply understandable, but it can be harmful. Levels of care are not rewards or judgments about worth. They are tools used to manage risk, safety, and available resources. Warmth, compassion, and care are not something you earn by deteriorating; they are something you deserve at every stage of illness and recovery.
When possible, part of recovery involves gently loosening the grip of these comparisons and refocusing on what support is available now, rather than what a particular level of care might symbolise.
When access is limited, treatment often requires creativity, collaboration, and advocacy. Outpatient clinicians frequently work to provide the best possible care within real-world resource constraints, while holding in mind what level of support would ideally be available.
Final Thoughts
Recovery from an eating disorder is rarely linear. It often involves periods of stability, struggle, intensification of support, and consolidation. Different levels of care exist because people’s needs change, and because eating disorders are complex, serious illnesses that deserve appropriately resourced treatment. Effective eating disorder treatment is almost always a collaborative effort between different providers and services over time.
If you’re unsure what level of care is right for you or someone you love, a thorough assessment with an experienced clinician is a good place to start. From there, treatment planning can focus on safety, support, and what will give recovery the best possible chance.