Eating disorders are among the most treatable mental illnesses but only if care matches the severity of the illness. Today clinicians face a growing challenge, how to guide patients and families toward the right level of treatment in an environment where convenience often overshadows clinical need.
The rise of telehealth and hybrid programs has expanded access to eating disorder care, especially for patients with mild symptoms or for those stepping down from more intensive settings. But the same innovations that made treatment more accessible have blurred lines between levels of care. Eating-disorder treatment is structured into tiers residential, partial hospitalization, intensive outpatient, and outpatient determined by medical stability, psychiatric risk, and nutritional status. This hierarchy isn’t bureaucratic. It is evidence-based, designed to prevent relapse and protect health. Some families and even clinicians assume that all forms of treatment offer comparable outcomes.
They don’t.
When severity and treatment intensity don’t align, the results can be dangerous. For example, Anna, a high school senior, developed a severe eating disorder after a family “Whole 30” challenge spiraled into restrictive eating. Her parents made the difficult decision to pull her out of school so she could enter a residential program. It wasn’t the most convenient choice, but it was the right one—and today, Anna is in recovery and thriving as a college student. Her story underscores a truth every clinician knows but sometimes struggles to act on: the right level of care, at the right time, saves lives. Patients and their caregivers must prioritize the level of care needed, not what is convenient or immediately accessible.
What the Medical Community Should Know
The consortium representing eating disorders care called REDC recently released a Care Matching Guidebook in conjunction with the National Alliance for Eating Disorders to help clinicians, payers, and families make decisions about treatment placement. The guide identifies five key principles for matching care to diagnosis:
- Safety first. Medical and psychiatric stability should always determine treatment intensity.
- Structured nutrition and monitoring. Higher-risk patients need medical oversight and meal support—these are not optional.
- Multidisciplinary care. Effective treatment requires coordinated medical, therapy, psychiatric, and nutritional teams.
- Evidence over convenience. Data-driven criteria and patient need should determine when to step up or step down—not convenience or overly simplified outcomes.
- Informed collaboration. Families and patients should understand what each treatment level can and cannot achieve and be part of the care process.
The Cost of Mismatch
According to REDC data, many patients only reach intensive programs after lower-level or purely virtual care fails to meet their needs. This “treatment delay” prolongs illness, increases relapse risk, and ultimately raises costs for both families and insurers. What begins as an effort to contain time investment and costs often result in longer, more expensive recovery trajectories.
Systemic Pressures on Providers
The economics of telehealth, coupled with insurance reimbursement models that favor lower -intensity programs, often incentivize undercare. Providers may hesitate to recommend escalation, even when medically warranted, fearing pushback or patient attrition. These pressures create a quiet, but significant gap between diagnosis and appropriate care.
Building a Better Compass
The REDC Care Matching Guidebook offers families, clinicians, and payers a roadmap for navigating these complexities. It defines what each level of care can accomplish, sets clear thresholds for escalation, and helps clinicians justify medical necessity to payers. Most importantly, it supports informed conversations with families, helping them see why sometimes the harder path is the right one.
Accessibility Should Enhance Safety, Not Replace It
Expanding care options is critical, but convenience should never replace clinical rigor. The future lies in integrating virtual and hybrid models into a full continuum of care—ensuring patients can step up or down seamlessly as their needs evolve. Accessibility should expand safety, not substitute for it.
Eating disorders are treatable when treatment intensity matches illness severity. For clinicians and families alike, the priority must be clear: recovery depends on care that fits the diagnosis—not the schedule.
For a detailed framework on care matching and treatment level decision-making, download the REDC Care Matching Guidebook here.
Dr. Jillian Lampert
Dr. Lampert has served on the Board of Directors of the Academy for Eating Disorders as the Electronic Media Portfolio Director and co-chair of the Academy for Eating Disorders Nutrition Special Interest Group. She is a Fellow of the Academy for Eating Disorders (FAED) and a member of the Academy for Nutrition and Dietetics, and BHN (Behavioral Health Nutrition) dietetic practice group. Dr. Lampert is the author of numerous book chapters and articles addressing the nutritional treatment of eating disorders, body image, sports participation, adolescent health, and disordered eating and she regularly speaks regionally and nationally on numerous eating disorder-related topics.
As someone with a personal experience with an eating disorder, Jillian strives to bring more care to more people and help people recover from an eating disorder. One of her primary goals in life is to have the kids and adults in her house (and everywhere!) have confident, loving relationships with their bodies and themselves.
