What Is Inpatient Like for an Eating Disorder?

Question by Amanda B: What is inpatient like for an eating disorder?
I’m a college student who is struggling with anorexia. I have been in therapy, nutrition counseling etc. for a couple months now. I have been doing everything they have been telling me to, but I haven’t gained weight. Because of this, they think I need to go IP. I really don’t want to go. I am scared and don’t understand why I need to go if I am doing what they are telling me to in outpatient. My family’s insurance only covers traditional treatment centers….not residential ones. What are they like? Do I have any other good options?
I see a physician once a week. I am not sure what type of tests I have had done, but I have had a lot of blood tests.

Best answer:

Answer by Letitia L
Have you had a full health check up, I mean of your physical health?

It is possible you have developed a problem with your thyroid hormones or digestive system which are preventing you from gaining weight. I am in recovery from quite a severe eating disorder, and I have completely messed up my digestive system so I can eat lots of food and not gain weight because my body simply cannot absorb most of what I am putting in my body.

So you really need to get that all checked out first if you have not.

Answer by Angela
I have struggled with anorexia for years, and at first I went to therapy, a dietitian, my family doctor, etc. Then I went to an eating disorders specialist, who suggested IP since I was at such a low weight and I wasn’t gaining. So I went for two weeks.

It wasn’t that bad. You do give up your freedom; IP is a locked unit. I’ll just tell you what I experienced, although every hospital is different. The eating disorder patients sit separately from the other patients (you didn’t say if you were going IP in a traditional psychiatric unit or one specific only for eating disorders; my IP was for people with a variety of mental illnesses. Still, I’m sure many things are the same either way.)

We were fed three meals a day, which we chose with the help of a dietitian. Because my blood tests basically sucked, I was also given a TPN, which is a line which is inserted in the vein of your arm, running through your body and resting above your heart. It feeds you nutrients that you need. That might be why they want you to go to IP; your blood tests might be showing a lack of nutrients or other issues, and you can only get that kind of thing in IP. They may think you need to be physically stable before you can continue with outpatient (it’s hard to work on recovery when your brain is depleted of food.)

You are expected to eat 100 percent of your food, or at least try to. Most IPs will give you a supplement like Ensure if you don’t finish your meal(s). You will not be allowed to go to the bathroom by yourself for one hour after meals (in case you purge), but don’t worry, the nurse or aide just hangs around the door; they don’t watch you going to the bathroom.

You meet with your doctor almost daily (my doctor only took Wednesday off.) You are blind-weighed daily (meaning they don’t tell you your weight; nor will they tell you how many calories your doctor has ordered for you to eat each day.) You meet in groups, like art and yoga and group therapy. The most helpful part for me was meeting with the dietitian daily, who explained why you need all these different nutrients and gave us handouts on things like body image, normal eating, etc. You probably will be asked to do some simple exercises, such as writing about the pros and cons of having anorexia (i.e. I want to be thin vs. I want to be healthy; that sort of thing.) IP also is big on encouraging journaling, and I both love to write and find it helpful in dealing with things.

There will be some down time, so take some books to read if you decide to do this. There are some rules; when I was in IP, we couldn’t shave our legs without a nurse’s aide in the shower room with us and we had to ask for dental floss. You won’t be allowed to bring in anything in glass bottles, so if you wear makeup (and I do), put it in a plastic container. No mirrors or any clothing with strings attached (hoodies with strings, bath robes, etc) are allowed; that’s for the protection of everybody. Cell phones, PCs and cameras also aren’t allowed.

The hardest part for me was getting used to the rules and having a roommate (I was 42 when I first went into IP, and I was very used to do things my way.) There are other people with the same problems as you to talk to, and many of the nurses and nurse aides are very nice to talk to. I would encourage you to go if that many people are recommending it, because they are seeing things more objectively than you are. I was very resistant too, but then I was starving and not thinking clearly.

My insurance also doesn’t cover residential. But you might want to check and see if your insurance covers eating disorders day treatment programs. I found out mine does, and plan to go to Renfrew’s 30-day program after the semester ends (I’m in graduate school) as I am still struggling; also, my years of anorexia have screwed up my metabolism so now I have to eat a lot more just to maintain my weight. I will live in an efficiency hotel and attend the program daily 9-4. Renfrew only treats people with eating disorders and only females. This might be an option for you in the future (or now if you are medically stable.)

If you are interested in reading more, I blog regularly about my own ongoing recovery from anorexia at angelaelackey.blogspot.com and the February section has several posts about my recent IP experience (I had to go back for refeeding due to a relapse.

Remember your family and treatment team often see things that you might not see if you are restricting or otherwise struggling. I know it’s hard, but try to trust that they are trying to help you. You want to recover so you are not fighting this for years.

Feel free to email me (it’s on my profile) if you have any other questions, concerns, etc.

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