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Inpatient vs Outpatient: Which Structure Is Best?

If you or someone you love is struggling with an eating disorder, seeking treatment is the best course of action. A professional eating disorder treatment program gives you the best chance of overcoming the disorder and returning to your healthy self. However, not all eating disorder treatment programs are the same. These programs last for different amounts of time, offer different services and employ different approaches to eating disorder treatment. To select the best program for your needs, you must compare all of these characteristics carefully.

When comparing different treatment programs and narrowing down your choices, one of the most important factors you will consider is whether the program is inpatient or outpatient in structure. 

Recognizing the Need for Treatment 

Before you can choose the right treatment program, you must first determine whether professional treatment is necessary. In some cases, it may be difficult to recognize the signs of an eating disorder in yourself or another person. Also, the early signs of eating disorders may differ from one person to the next.

Some of the anorexia nervosa early symptoms include:

  • Restrictions on food intake. 
  • Avoiding social situations, especially when food is involved. 
  • Preoccupation with weight loss or a fear of gaining weight. 
  • Distorted body image. 
  • Excessive exercise. 
  • Weight loss or being underweight. 

Some of the early symptoms of bulimia nervosa may include:

  • Eating large amounts of food in one sitting. 
  • Purging behaviors, such as induced vomiting, abuse of laxatives and/or excessive exercise to burn extra calories consumed. 
  • Distorted body image.
  • Obsession with weight loss and/or a fear of gaining weight. 

In many cases, people with bulimia will not be underweight. In fact, some people with bulimia nervosa have a higher than normal weight. 

Defining Inpatient and Outpatient Programs

Inpatient eating disorder programs, which are also known as “residential” eating disorder treatment programs, are conducted within a residential facility. With an inpatient program, clients are admitted to the treatment facility at the beginning of the program and won’t leave until the program is complete. Outpatient treatment programs, on the other hand, don’t require clients to stay in the treatment center overnight. Instead, clients will come to the treatment facility during the day only. 

Each of these program structures offers different advantages and disadvantages. Considering the pros and cons of outpatient and inpatient programs will help you to make the best choice for your needs.

Advantages and Disadvantages of Inpatient Treatment Programs

Some of the advantages of inpatient treatment programs include:

  • Constant supervision – When a client is in an inpatient treatment program, they will be under continuous supervision from medical and eating disorder treatment professionals. This means that the client will be more likely to adhere to the requirements of the program and avoid disordered eating behaviors that could lead to setbacks. For example, in clients with bulimia, being admitted to an inpatient program reduces the risk that the client will be able to sneak to the bathroom to purge after meals. 
  • Continuous support – During the eating disorder treatment process, clients are likely to struggle with their emotions. Clients may feel frustrated, deal with body image issues and face other issues that make each day a challenge. Inpatient treatment programs offer continuous support to clients in eating disorder treatment. With this support, clients will have a better overall experience and a better chance of making a full recovery. 
  • Intensive treatment – Inpatient programs are much more immersive and intensive for clients than outpatient treatment programs. More intensive treatment may improve outcomes for clients, reducing the risk of relapse after the treatment program ends. 
  • Fewer distractions – When a client is in an inpatient program, they can shut out all the distractions of the outside world and focus all their attention on recovery. With fewer distractions, it may be easier for clients to complete the treatment program successfully.  
  • Better success rates – Because of all the other advantages listed above, inpatient treatment programs tend to have higher success rates than outpatient program, especially for clients who needed a lot of support. 

Some of the disadvantages of inpatient eating disorder treatment programs include:

  • Higher costs – Because inpatient treatment programs require overnight accommodations, they tend to cost more than outpatient treatment programs. However, it is important to note that some of these expenses may be covered by health insurance, depending on the specifics of the situation. 
  • More effort – Inpatient eating disorder treatment programs are more intensive, which means that more effort will be required on the part of the client. For example, a client enrolling in residential bulimia nervosa treatment is going to be more committed to the treatment process than a client in an outpatient bulimia nervosa treatment program. 
  • More time – Because clients are required to remain at the treatment facility day and night, inpatient treatment programs require a greater amount of the client’s time. 

Advantages and Disadvantages of Outpatient Treatment Programs

Some of the advantages of an outpatient eating disorder treatment program include:

  • More flexibility – Outpatient eating disorder treatment programs don’t require clients to spend as much of their time at the treatment center, which means clients can continue to meet their other obligations. 
  • Lower costs – Because outpatient eating disorder treatment programs do not involve overnight accommodations, they tend to cost less than inpatient programs. 
  • Less intensity – Outpatient eating disorder treatment programs are not as intense and don’t require as much commitment. As a result, clients who are hesitant to enter eating disorder treatment may be less resistant to an outpatient program. 

Some of the disadvantages of outpatient eating disorder treatment programs include:

  • Lack of supervision – Outpatient eating disorder treatment programs provide supervision during the day, but clients lack supervision when they return to their homes in the evening. Because clients are not supervised at this time, they may be more likely to engage in disordered eating behaviors. For example, a client receiving treatment at an outpatient bulimia treatment center may return home in the evenings and engage in purging. 
  • Lower levels of support – Outpatient eating disorder programs do not provide continuous support to clients. When clients are not actively engaged in treatment sessions at the facility, they may need to rely on other sources of support, such as friends and family. 
  • Less immersive – Because outpatient eating disorder treatment programs are not as immersive, clients may be less likely to adhere to all the requirements of the program. For example, a client in an outpatient bulimia treatment center may stop following the program’s nutritional recommendations when outside the treatment facility. 
  • Lower success rates – Because of the issues listed above, outpatient eating disorder treatment programs may have lower success rates than similar treatment programs with an inpatient structure. 

Choosing Between Inpatient and Outpatient Eating Disorder Treatment

There are pros and cons to both inpatient and outpatient eating disorder treatment, so it may be difficult for some clients or family members of clients to make the best choice. To select the treatment program that is best for you or your loved one, consider your priorities carefully. It is also a good idea to take the characteristics of the client into consideration. 

For example, if the client is someone who has a strong support system outside the treatment center and is committed to following all the treatment program’s guidelines, inpatient treatment may not be necessary. Likewise, if the client has not been struggling with the eating disorder for very long and/or is experiencing only mild to moderate symptoms, they may recover fully in outpatient treatment. On the other hand, a client with severe symptoms, a long history of disordered eating behaviors and/or limited support from family and friends would be better served by an inpatient treatment program. 

Seeking Outpatient or Inpatient Eating Disorder Treatment at Monte Nido

Whether you are interested in residential bulimia nervosa treatment or an outpatient program for clients with anorexia nervosa, you can find the services you need at Monte Nido. Monte Nido operates multiple facilities all across the nation, so it is easy to find eating disorder treatment near you. At Monte Nido, we understand that different clients may benefit more from different approaches to eating disorder treatment. For this reason, we are proud to offer all levels of care to our clients. 

Residential Treatment at Monte Nido

Monte Nido’s residential treatment programs are conducted in a facility that provides all the comforts of home so our clients can be as relaxed as possible during the program. Residential treatment programs include 24-hour nursing and continuous access to psychiatric and medical care. To give our clients the best experience possible, we also offer a high staff-to-client ratio. 

All of our residential treatment programs include evidence-based treatments that have been shown through both research and our experiences to be effective. Clients will have access to Cognitive Processing Therapy, nutritional programming, 12-step meetings, cognitive behavioral therapy, dialectical behavioral therapy and other services. Every treatment program is individualized based on the client’s specific disorder, preferences and other characteristics. 

Day Treatment at Monte Nido

Monte Nido’s day treatment programming is available to clients who cannot enter residential treatment programs, as well as clients who have already graduated from a residential treatment program but need continued support. We offer two different day treatment structures: a partial hospitalization program and an intensive outpatient program. While our intensive outpatient treatment program operates five days per week, our partial hospitalization program provides services seven days per week. 

Monte Nido’s day treatment programs include both individual and group therapy sessions. Some of the services available to day treatment clients include cognitive behavioral therapy, dialectical behavioral therapy, cognitive processing therapy, nutritional programming, support group meetings and psychiatric sessions. When clients are ready to leave the program, we also offer comprehensive discharge planning to ensure that the client has the best chance of success outside of treatment. 

Monte Nido accepts most types of health insurance coverage. Many clients find that the entire cost of their treatment program is covered by health insurance. In cases where health insurance does not cover the full cost of eating disorder treatment, we are happy to work with you to find a suitable solution. We understand that every client has a unique experience with their eating disorder. Clients have different backgrounds, as well as different physical or mental health issues that complicate treatment. For this reason, we work closely with every client and family to design a customized treatment program that meets the client’s needs as effectively and thoroughly as possible.

If you or a loved one is experiencing the symptoms of an eating disorder, it is time to get the professional help you need. Please contact Monte Nido today to schedule an appointment with our team or to learn more about the treatment programs we offer. 


Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.