Specialized inpatient eating disorder treatment programs provide medical and psychiatric stabilization for individuals with the most acute eating disorders. Many will never need inpatient treatment during their journey towards recovery, but for those who do, the care they receive on inpatient units is lifesaving.

So, it’s important to understand when an individual might need the added support an inpatient treatment program can provide. Determining the right level of care someone needs isn’t an exact science, but below are five common symptoms that could factor into making the recommendation for the inpatient level of care.

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1. Low Body Weight

It might seem obvious, but low body weight can be, in and of itself, very dangerous. This is especially true for people who maintain a low weight for an extended period, or for those who experience a rapid and significant weight loss.

The Academy of Eating Disorders recommends inpatient treatment for anyone at or below 75% of their ideal body weight. This is a general suggestion for medical professionals, not a hard and fast rule. What we do know for sure is that people with severely low body weights are at a much higher risk for things like dizziness, fainting, osteoporosis, amenorrhea as well as the more acute and life-threatening complications discussed below.

2. Electrolyte Imbalance

Electrolytes are salts and minerals, like potassium and sodium chloride, which allow our bodies to perform most of its vital biochemical functions. For example, potassium helps to keep blood pressure stable and regulate heart contraction, and calcium helps with things like blood clotting and cell division.

Eating disorder behaviors like purging and restricting can cause our bodies to produce too much or too little of these electrolytes. When this happens, it’s known as an electrolyte imbalance, and it can have catastrophic consequences. Here are a few common examples of electrolyte imbalance seen in patients with eating disorders:

• Hypokalemia, or low potassium, can be caused by purging behaviors like self-induced vomiting or laxative abuse. Low potassium levels can lead to heart arrhythmias and a weakened heart, which in turn can lead to sudden death.
• Hypernatremia, or too much sodium in the blood, can also be caused by purging behaviors. Think of it as dehydration on a cellular level. Hypernatremia can create a range of problems like cramps, seizures, and comas.

3. Bradycardia

Did you know that eating disorders can cause your heart to shrink? It’s scary to think about, but it’s true.

When we lose weight, much of what we lose comes from our muscles shrinking. And in cases of low body weight or significant weight loss, the heart, which is a muscle, can start to shrink. When this happens, our bodies will slow our heart rate to protect the weakened heart muscle. This abnormally low heart rate is called bradycardia.

Bradycardia is a common and potentially deadly symptom of eating disorders. Individuals with heart rates in the 40s and lower are at risk for arrhythmias, which can lead to sudden cardiac arrest and death.

4. Psychiatric Instability

Many individuals are referred to inpatient units primarily for psychiatric stabilization. For example, those living with an eating disorder like anorexia nervosa and another co-morbid condition like depression may find that their depressive symptoms interfere with their participation or meaningful engagement in lower levels of eating disorder care. These individuals may need hospitalization to stabilize depression symptoms before they can return to a lower level of care. 

Similarly, individuals with eating disorders who may have suicidal thoughts or behaviors may be referred to an inpatient program for their safety and to help them address these issues.

5. Unwillingness to Engage in Treatment

Occasionally, individuals admitted to an inpatient program are medically and psychiatrically stable but are refusing to engage in treatment at a lower level of care. For example, an individual already in treatment in a residential or partial hospitalization program reports that they have had nothing to eat in 24 hours and that they are refusing all food and liquids. This person may be medically stable at the moment, but could still be referred to an inpatient setting to prevent their current medical condition from deteriorating.

Ultimately, the best way to determine if someone needs inpatient eating disorder treatment or hospitalization is to have them evaluated by an eating disorder specialist. An eating disorder specialist will be able to assess the whole person – medically, psychologically, as well as any historical information and can provide a care recommendation based on the combination of information they receive.

You are not alone. We’re here to help.

Remember, recovery is possible, and we at Monte Nido are here for you at every level of care, all along the way. If you have questions about inpatient eating disorder treatment or your future treatment at Monte Nido, please reach out to us. Begin your journey to recovery today

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