At the Columbia Center for Eating Disorders, we conduct eating disorders research and we also offer treatment to many individuals struggling with these disorders. Often, people are unsure about what it is like to receive treatment from an institution where they are also participating in research. We’ve put together some answers to commonly asked questions about treatment below (For answers to other types of commonly asked questions about our program see these two related posts.):
Is the treatment experimental?
In most cases, the treatment offered at Columbia is not experimental. Treatment-seeking individuals with anorexia nervosa or bulimia nervosa who are eligible participate in different research studies and then receive treatment independent from the research at no cost, in gratitude for your contribution to science and helping us learn more about eating disorders. The treatment most of our research participants receive is described below in more detail.
Occasionally, our research will involve testing out a new, experimental treatment for eating disorders. This could be a medication or a talk therapy. Participation in this research is entirely voluntary, and requires formal consent including a discussion with the researcher running the study about the risks and benefits of the experimental treatment. In some cases, study treatments are delivered in conjunction with the other, non-experimental treatments, described below.
What types of treatment do you offer?
Outpatient treatment: At Columbia, we offer outpatient treatment for individuals with eating disorders who have participated in our research. What we offer, and to whom, depends on the types of studies being run. Right now, we offer outpatient treatment to people who have either 1) bulimia nervosa or 2) have many symptoms of anorexia nervosa, but who are not at a dangerously low weight. The treatment we offer is called Cognitive Behavioral Therapy (CBT), which is a therapy that focuses on challenging beliefs that maintain the eating disorder, and changing eating disordered behaviors through self-monitoring, regular eating, and strategic problem-solving. We typically offer twenty 50-minute sessions of CBT with one of our psychologists or psychiatrists over the course of 5-6 months. A lot of research has been done demonstrating that CBT is an effective treatment for many individuals with bulimia nervosa in helping to stop the cycle of bingeing and purging and normalize eating. Additionally, if it appears that psychiatric medication might provide additional benefit, a psychiatrist will meet with you to manage this aspect of care.
Inpatient treatment: We also offer voluntary inpatient treatment for research participants struggling with either anorexia nervosa or bulimia nervosa. Inpatient treatment occurs on a hospital unit with clinical staff available around the clock. The goal of this type of treatment is to help patients become medically stable, normalize eating habits, and reach and maintain a minimally healthy weight within a highly structured setting. These goals are met through supervised meals and snacks, medical monitoring, and individual, group, and family therapy.
For individuals with anorexia nervosa who will need to gain a significant amount of weight to be considered minimally healthy, an inpatient stay may last several months. For individuals with bulimia nervosa, for whom the primary goal of treatment is breaking the binge-purge cycle, an inpatient stay is typically shorter, approximately 4-6 weeks.
How does the treatment experience differ from treatment in non-research setting?
The treatment you can receive at Columbia is similar in many ways to treatment you might receive elsewhere; however, there are a few differences worth noting.
First, we are generally only able to offer treatment to individuals who are eligible for and interested in research participation. Inclusion criteria for research will vary from study to study.
Second, we are able to offer a fixed number of sessions (typically twenty) for our outpatients, whereas non-research providers may be able to offer you a longer course of treatment, if necessary.
Third, since treatment on our inpatient unit is not contingent on review or approval by insurance companies, and many of our research studies require participation at multiple time points (e.g., when underweight and again when weight restored), patients are encouraged to remain in treatment until they reach a minimally healthy weight and are able to maintain this weight for several weeks. This means that patients may be able to be in inpatient treatment for longer than they otherwise would be.
What if the treatment is not helpful or what if I don’t get better?
For some individuals in outpatient treatment, symptoms do not fully remit by the end of the course of treatment that we are able to offer. If symptoms have not improved at all or have worsened, you and your therapist will evaluate the potential barriers to progress and whether it makes sense to seek a higher level of care (e.g., a day program, inpatient hospitalization). Appropriate treatment options will be identified.
If you have benefited from the treatment, but are in need of further treatment (for the eating disorder or other related or unrelated problems), referrals will be provided. For those ending a course of outpatient treatment, you may be provided with resources for other outpatient providers. On the inpatient unit, we expect that everyone who leaves will need some level of continued treatment and support. Staff on the inpatient unit will begin working with you soon after your arrival to begin brainstorming appropriate next steps and the resources available to you.