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Question: Last week my son informed his therapist that he has an eating disorder and he thinks he needs to go into a treatment program. My husband and I were shocked, my son is thin but he is a runner and he looks normal compared to most of the boys. We want to get our son the best care possible but we have had difficulty even getting calls back from some of the local eating disorders programs, and they all seem to be geared for girls. Should we be looking for a specialized program for boys and men? Is this the kind of thing where he is going to need to leave school for a month or can he be treated a couple times a week with a therapist? We just don't know where to start.
Answer: The ideal treatment program does not exist. It does not matter what issue you are dealing with, from eating disorders to anxiety to addiction, since every person has such individual circumstances, strengths, and symptoms there will never be a perfect fit. I would love to tell you about a great program for boys and men with eating issues, and there are probably a couple but if they are out of state or a zillion dollars you may be better off focusing on factors other than gender in finding the right fit for your son.
So start by doing your homework on the web and try to find someone in the field to talk to who does not have a financial interest in which program you pick. National Eating Disorders is a non-profit that can provide resources (http://www.nationaleatingdisorders.org/). Another track is to call an nationally renown program like McCallum Place in Missouri (http://www.mccallumplace.com/) and ask them if they have any recommendations for your area.
After you have a rank list of the local programs contact your insurance company and see what they cover. While it might sound cold to pick a treatment option based on what insurance will pay for, eating disorders, like any addiction, often take more than one stint in treatment to crack. If you go bankrupt, which can honestly happen, you won't be able to provide your son with any treatment and his condition may worsen if he feels like he is causing a great deal of financial stress to the family. Often insurance companies want to make sure you have tried some less intensive interventions first, like out patient therapy with an eating disorders specialist, before they are willing to pop for a 30-60 day stay in a treatment facility.
To be frank insurance companies HATE eating disorders because they represent a huge financial drain which can last for decades. This has led them to create barriers to paying for treatment which have led to the closure of a number of programs and reduction in staff at others. You may not be getting a phone call or an e-mail back right away for some of these reasons but if you don't get a good feeling when you actually do talk to someone try to go on to the next program. Families really need to partner with treatment providers to make sure that any gains can be sustained when a person leaves treatment.
Some factors that impact the severity and course of treatment for an eating disorder are the amount of time the person has had the eating disorder, how much of the persons time and thought is devoted to food and eating, how much shame and guilt is associated with food.
There is a difference between an eating disorder and disordered eating. Disordered eating are the behaviors that a person with an eating disorder might display (restricting, binging, purging, hyper exercise after eating...) without the emotional obsession with food. A person with an eating disorder may still obsess about everything they put in their mouth even during periods where they have no disordered eating behaviors.
A large percentage of people with eating disorders may also have another issue that needs treatment and may shift between negative coping skills to deal with uncomfortable emotions. We often see a triangle with Eating disorders at one point, self injury at another, and risk taking behaviors (ex.) drugs and alcohol, unprotected sex, shoplifting, unsafe driving...) at the third. People may shift from one point to another as they try to convince themselves that they don't have a problem.
The key to treatment for eating disorders is to find another way to get the emotional relief that the disordered eating behaviors have provided in the past. Eating disorders are the hardest addiction to successfully treat because the abstinence model is impossible. You can stop drinking, gambling, self injuring, etc... but you cannot stop eating and not eating.
Treatment programs will first work to develop healthier coping skills to deal with uncomfortable emotions and then go back and find out how the eating developed so if there is an old trauma that needs healing it can be dealt with instead of just covered over by new and better coping skills.
It is hard to say what your son will need without more information but I can tell you that his prognosis is excellent just because he has stated he is willing to get help.
Your son is likely to get well no matter which treatment program he goes to if he really wants to move on. All the programs work if the clients work with the program. Be prepared that he may have issues with food for the rest of his life but he is fully capable of moving on to a life that is so full of good things that eating issues seem like a thing of the distant past.
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