Inpatient treatment for eating disorders

The decision to undergo inpatient therapy is an unfamiliar and far-reaching step. Expectations, fears, skepticism, but also a little curiosity are all part of it. The ward’s therapy program is embedded in a milieu-therapeutic community and consists of various phases. The structured daily routine is organized by the patients together with a very experienced team. Even somatically complex clinical pictures can be adequately addressed through interdisciplinary cooperation with specialists at the university hospital. Our treatments are flexible, practice-oriented and take into account the individual situation of each person.

Target group

The offer is aimed at patients who are mainly affected by:

• Anorexia nervosa
• Bulimia nervosa
• Binge eating
• ARFID

The step program

Depending on the type and severity of the disorder, we offer various treatment programs that are structured in stages. After initial physical and psychological stabilization, patients are increasingly given more freedom and take on more responsibility for themselves. In this way, what has been learned is integrated into everyday life and practiced in order to achieve lasting success even after inpatient treatment. Sufficient time and energy should also be devoted to preparing for discharge; a regular daily structure is an important prerequisite for the normalization of eating behaviour.

The therapy program consists of:

• Therapeutic individual and group sessions
• Movement therapy
• Creative therapy
• Muscle building
• Nutritional Counseling
• Information (psychodidactics) about eating disorders and their therapy

The group discussions give patients the opportunity to expand and enrich their own perception through the important experiences of others, through food for thought, solution strategies and emotional experiences. Depending on the individual situation, relatives can be involved in the treatment.

Life on the ward

The 15-bed ward offers a therapeutic environment and is a place for intensive self and other reflection. Patients can also relax here and spend their free time and socialize with others in as pleasant an atmosphere as possible. Life on the ward is generally structured in such a way that group therapies take place mostly in the mornings and individual therapies in the afternoons. In later phases of treatment, the afternoon is mainly reserved for an individual, external program.

Normalization of eating behavior

People with eating disorders no longer know what and how much they should eat. Your sense of hunger and satiety is disturbed. The normalization of eating behaviour is a focal point of the treatment. The aim is to return to a regular intake of 3 main meals and 2-3 snacks. The food on the ward is prepared in the kitchen of the University Hospital Zurich according to the latest nutritional findings and in defined quantities. Patients eat together, keep a food log and discuss the meal plan.

In the course of therapy, meals are increasingly taken externally. Cooking is also part of the therapy to practise handling food.

Normalization of weight in case of underweight

For underweight patients, the aim is to normalize weight and achieve a minimum weight(BMI 18.5 -20 kg/m2 for women; 19.5 -21 kg/m2 for men). This complex process is very individual and can take different lengths of time. Ideally, the minimum target weight is achieved within a single inpatient therapy episode. However, it is also possible to complete the treatment in different stages.

It is very important that the therapy is not regarded as finished when the minimum target weight is reached. Weight stabilization is very important for the further course of treatment and requires intensive psychotherapeutic support, ideally in an outpatient multimodal program or through outpatient psychotherapy.

Patients who are of normal weight at the start of treatment should keep their weight constant during treatment.

Dealing with issues that can influence the therapy

As a rule, eating disorders not only cause difficulties with food, figure and weight. Depending on the individual situation, depressive moods, other psychological problems or tense relationships with family members can also occur. For the treatment of eating problems to be effective, it is important that patients also reflect on their lives as a whole during their time on the ward and develop new strategies for dealing with problems.