Hospitalization for Anorexia Nervosa and Other Eating Disorders

Providing Strucuture, Support and Medical Management

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Although hospitalization for mental disorders is relatively rare, eating disorders including anorexia nervosa and bulimia nervosa are extremely dangerous and potentially deadly diseases, and so in some cases medical hospitalization is necessary.

Inpatient hospitalization for eating disorders provides patients with additional support, structure and round-the-clock medical care and monitoring. It may be helpful to understand what will happen during an inpatient hospitalization for an eating disorder.

Hospitalization for Eating Disorders

Inpatient hospitalization is the most intensive level of treatment. It normally doesn't last as long as outpatient care or residential treatment. Because hospitalization is very expensive, many patients only stay at the inpatient level of care until they have been medically stabilized enough to continue treatment at a lower level of care. Patients may often be transferred to residential treatment or a partial hospitalization program when their vitals are stable, they have resumed some eating on their own with structure, and they have gained some weight. They may still require high levels of support and structure, but this can usually be provided at a nonmedical residential treatment center or a partial hospitalization program, which a patient attends during the day, but returns home at night to sleep.

The inpatient hospital treatment team will usually consist of psychiatrists, physicians, therapists, dietitians and nursing staff.

It may also include other specialists if needed.

Intensive psychotherapy, or counseling, is usually a routine part of inpatient hospitalization. Because patients are at the hospital 24 hours a day, seven days a week, patients may be able to have sessions with therapists more frequently than on an outpatient basis.

In some hospitals they may be able to meet with their individual therapist several times during the week. Hospitalization may also include group therapy sessions and family therapy sessions if patients are well enough.

Hospital staff also will provide basic nutrition information and nutritional counseling, and a dietitian will plan meals. If the patient can't eat enough to regain or maintain weight, doctors and other treatment team members may recommend medical refeeding, which involves inserting a tube through the patient's nose down into the stomach. This tube then can carry nutrition directly to the stomach. Medical refeeding is one of the unique services that inpatient hospitalization is able to provide.

Another form of support that inpatient hospitalization is able to provide is supported meals. Staff members will typically supervise all of a patient’s meals to provide support and monitor intake. They will be available before and after meals to process any urges that patients are experiencing and to support patients during these anxiety-provoking times.

The medical management available at the inpatient level is extremely important. Many patients require monitoring of vitals, intravenous fluids, medication, and laboratory tests. People who are hospitalized with eating disorders frequently experience medical complications, which can affect all systems of the body. Inpatient units are often connected to or affiliated with a full hospital which can provide access to a number of medical specialists, including cardiologists, neurologists, gastroenterologists, etc. They also provide the patient with round-the-clock nursing staff.

Who Should Be Hospitalized?

Any time a person is experiencing medical complications due to their eating disorder including but not limited to an unstable heart rate or blood pressure, fainting, or bleeding from vomiting, they should be screened for hospitalization. Patients may require hospitalization if they are severely malnourished and/or have lost a great deal of weight and are at risk for refeeding syndrome. It can also be appropriate when someone is suicidal, if the patient lives far away from treatment providers, or if there are other complicating medical or psychiatric factors.

Whenever possible, eating disorder hospitalization should take place in a specialized medical unit for eating disorders versus in a general medical or psychiatric unit. Eating disorders require a unique collaboration between many medical and mental health specialists and general hospital units may not be set up to provide the appropriate care.

Although hospitalization can be scary, it is also a very necessary component of treatment for many people. If your therapist, physician or dietitian is recommending hospitalization, please go. It may save your life. Choosing not to go to the hospital when needed can be extremely dangerous.


Source

American Psychiatric Association. American Psychiatric Association Practice Guidelines for the treatment of psychiatric disorders: compendium 2006. American Psychiatric Pub, 2006.

 

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