Outpatient Strategies for Managing Eating Disorders: When Is Outpatient Care Not Enough?

Eating disorders (EDs) are prevalent in the adolescent and young adult populations, and there is a significant burden of disease with high morbidity and mortality. Many patients do not initially seek ED subspecialty care, and primary care clinicians must identify and treat these patients with the help of a multidisciplinary team of ED-specialized dietitians, therapists, and psychiatrists. The primary care clinician must also be able to monitor for and identify medical instability or failure of outpatient treatment and recommend a higher level of care if necessary. Higher levels of care include medical inpatient treatment, psychiatric inpatient treatment, residential programs, partial hospital programs, and intensive outpatient programs. For optimal treatment outcomes, it is critical to select the appropriate level of care for each patient and step down as indicated.