How Do I Know If I Need A Higher Level Of Care?

by | Eating Disorder Recovery

Making the decision to pursue higher level of care can be difficult. There are often many real factors to consider. This can, understandably, bring up questions and concerns. You may be asking yourself “Is it necessary?” or “Am I really ‘sick enough?’” Below are 5 common indicators of needing a higher level of care.

You feel overwhelmed. 

Eating disorder recovery is hard. It takes energy to fight your eating disorder every day. In fact, it’s a full time job. You likely have other responsibilities that require your energy too – going to school, going to work, taking care of others, etc. You only have so much energy so it’s completely valid if you feel overwhelmed. If this is the case, you may benefit from higher level of care. It can offer you an increased level of support that gets you through the tough times. This includes assistance in challenging unhelpful thoughts and siting through uncomfortable feelings. It also includes meal support of varying degrees. 

You feel stuck and/or that your progress is too slow.


Eating disorder recovery takes time and is often not linear. At an outpatient level of care, it is likely that you only have 1-3 hours of support per week from a provider. This means that you have to fight your ED on your own for the other 165-167 hours per week. That’s a lot! You also having to balance the time you spend on recovery with your other responsibilities. You may reach a place in recovery where you feel stuck and/or that things are progressing too slowly for your liking. This is a good time to reassess whether this is the right level of care for you. A higher level of care can help you prioritize your recovery and, ultimately, speed things up.

You are not medically stable.


Medical stability is determined by a physician. Some factors that may contribute to your medical stability include severity of behavior use, mental health status, lab work, vital signs, and weight/weight trends. Please note that not every doctor is eating disorder informed. It is important to find one that is for an accurate assessment. Although it may not be possible, it is preferable to find one that is Health At Every Sized © aligned to avoid weight bias. If it is determined that you are not medically stable, the decision to pursue higher level of care could be a matter of life or death.

Your safety is at risk.


Suicidal thoughts are a serious threat to safety. It is important to tell your treatment team if you are having them so that they can help you come up with a safety plan. If it is determined that your safety is in question, once again, the decision to pursue higher level of care could be a matter of life or death. Note: If you need immediate support, you can call the National Suicide Prevention Lifeline (800-273-8255) or go to your nearest emergency room.


Your treatment team recommends it.


Your treatment team knows you well and can help determine what level of care is right for you. This involves a certain level of trust, which can be tough when your eating disorder voice is loud. Ultimately though, your treatment team’s job is to help you meet your needs and ensure your safety. 

If you do decide to pursue a higher level of care, you may still feel conflicted. That’s ok! You’re allowed to take the time you need to process your emotions. You can also hold space to be proud of yourself for prioritizing your needs. You are making an investment in your health that can help you to achieve long-term recovery and be more independent in the future. 

Closing Thoughts

If you need more support in making this decision, we can help. We offer free, 15 minute discovery calls to match you with the dietitian that best fits your needs. Our dietitians have experience helping clients navigate the transition to higher level of care, both logistically and emotionally.

Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland. and College Park, Maryland. We offer virtual services across the state of Maryland. Virginia, Washington DC. Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food. Contact us for more information. And to schedule a discovery call.

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sydney richards courage to nourish

Syndey Richards, RD, LD

As a professional who used to work in a corporate setting, I have seen the negative, daily impact that diet culture has on people’s lives. This led me to discover intuitive eating and Health At Every Size ©, which I now use in working with clients in recovery at the partial hospitalization and intensive outpatient level. I love helping clients find a way of nourishing, moving, and viewing their body that is satisfying and sustainable.

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