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The Value of In-Person Eating Disorder Treatment

By Margherita Mascolo, MD, CED-S| 4 Min Read | October 5, 2023

The COVID-19 pandemic accelerated the adoption of virtual behavioral health services, including in the treatment of eating disorders. Due to travel restrictions and the inability to gather in person, access to care became even more difficult for patients with eating disorders. In response, most treatment centers either opened or expanded their virtual offerings, and even entirely virtual programs opened. With pandemic restrictions easing and life going back to normal, what is the best care for patients with eating disorders? How does one choose between in person care and virtual care?

Virtual care offers several advantages, particularly in its convenience and its ability to provide access to care for patients in remote areas. However, it’s not the best fit for everyone, and there are many advantages to in person eating disorder treatment.  Virtual treatments rely heavily on technology to deliver care, so any technical difficulty, from unstable internet connection to sudden internet disconnection to computer malfunction, can disrupt care and increase stress and anxiety in the patient.  Patients receiving virtual-only care may feel less supported and less like a part of a team given the remote nature of treatment.  In addition, patients receiving solely virtual care may find it harder to receive empathy and compassion from providers and fellow patients as body language and facial expressions do not fully translate in the virtual space.   

In-person eating disorder care has four key advantages, beginning with the environment of care.  At Inner Haven Wellness, healing begins when the patient steps foot in our center.  Our space is intentionally designed to promote healing, acceptance, support, and safety, both psychologically and physically.  Patients don’t have to worry about privacy or technical issues;  they can simply walk in, take a deep breath, and begin their recovery journey.   

The second significant advantage of in-person treatment is personal interactions with staff and fellow patients.  Building trust and forming the therapeutic alliance is easier when the clinician is able to physically sit with the patient and assess them.  The clinician is also better able to perform a physical assessment and evaluate body language, thus able to perform a more thorough comprehensive evaluation.  For example, subtle signs of discomfort or anxiety, like fidgeting or leg shaking, are easier to pick up in person than on a computer screen that only shows the patient’s head.   

In-person visits also allow patients to assess the professionalism and body language of their therapists, which contributes to building trust.  Patients can even connect with fellow patients on a deeper level—they are all in a room together during group and they are interacting during meals and during free moments between sessions. 

Thirdly, in-person care allows for a broader range of therapeutic modalities, such as somatic experience, EMDR, and movement-based therapy.  These modalities can only be delivered in person and add to the depth of a patient’s treatment experience.  Lastly, while recent studies suggest comparable results for virtual treatment compared to in-person treatment in behavioral health and in eating disorders, these studies are all new and lack extensive follow up data compared to the decades of evidence-based research supporting in-person treatment.   

In conclusion, there continue to be many advantages to in-person treatment for eating disorders, and we are passionate about bringing these advantages to our patients at Inner Haven Wellness. Our clinicians are trained to pick up on subtle physical cues that may be difficult to see on a computer monitor.  From a medical standpoint, nothing beats a physical assessment, especially for eating disorder patients who may have body dysmorphia or difficulty reporting their weight or meals accurately.  Importantly, in-person care can provide additional motivation for patients who remain ambivalent about treatment.  All this being said, it is up to the provider and the patient to ultimately decide which type of programming will best serve the patient and their recovery. 

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Eating Disorder Doctor Near Madison, WI - Margherita Mascolo