Remote Eating Disorder Treatment

Dr. David Wiss

May 20, 2021

Eating Disorders

When COVID-19 put the entire globe on lockdown in March 2020, it soon became evident that the world was changing in ways that would become permanent. Anyone who was yet unfamiliar with videoconferencing technologies like Zoom or Skype, quickly became savvy with these tools. For those health professionals who were previously providing a combination of face-to-face as well as “virtual” care, the transition to telehealth was immediate. For others, it was a slow process met with much resistance. But, like it or not, when the pandemic became official, full days of virtual care became the new norm. For many practitioners, this transition was exhausting, leading to “Zoom fatigue” and burn-out. Naturally our providers (and our clients) also had many questions about the viability of this model:

• Does online counseling work as well as in-person care?
• Will body language and other nuances be missed in a virtual setting?
• Will people feel less connected to their provider through a video screen?
• How does this impact the mental health of the provider?
• Will I be able to find sustainable recovery from bingeing and purging?
• Does virtual eating disorder treatment work?

It has been our experience that, in many cases, online counseling for eating disorders works just as well as in-person care for most recovery processes. Removing the stress of driving in city traffic, finding parking, and the fear of being late to the appointment seems to contribute to positive outcomes. We have found that during this transition, people are less stressed about their meetings (albeit perhaps more stressed about other things), are generally on-time, and cancel less often. When people are less stressed, they tend to restrict less, stress eat at night less, and can find recovery for disordered eating, including those with food addiction symptoms.

All our forms and paperwork were adapted for completion online. We find it very important to assess dieting history and levels of dietary restraint before making any nutrition or recovery-related recommendations. All our handouts can be shared over email and on screen. The use of recovery-related accountability apps makes everything possible. We can even conduct blood and stool tests through the mail (when clinically appropriate), in addition to shipping dietary supplements (when necessary).

While the initial few months of Zoom sessions may have been a bit awkward, most of us quickly adapted. We found that we can transmit facial expressions and other gestures virtually. We have had incredible success providing treatment for binge eating disorder and treatment for bulimia nervosa online, and using apps. In fact, the COVID-19 lockdown was the impetus for the creation of the Wise Mind Nutrition app, which is designed specifically to help people recover from disordered eating patterns.

The experience of connecting the patient with the provider can occur in a video setting. In fact, some people feel more comfortable discussing their issues during Zoom sessions than in person. In short: virtual eating disorder treatment works, especially when there is a full treatment team! By leveraging technology, we can recreate all facets of the “standard” treatment experience. We even hold cooking classes entirely online!

We are not suggesting that being in the same room with a therapist, dietitian, or doctor can be wholly replaced by virtual platforms; however, we do suggest that we have had great success with this modality and that some providers can avoid burn-out by conducting slightly shorter sessions than the usual clinical hour. Many of our patients were able to find sustainable recovery during the COVID-19 pandemic and we plan to continue helping people find healing this way moving forward.

There is no single treatment for eating disorders. Some therapies do require experiential care. For example, food exposure therapy or other activities for body image disturbance. Many of these assignments and activities can be done through the app. As long as there is a provider involved, there are few limitations to virtual eating disorder treatment for some forms of disordered eating. Treating binge eating disorder is entirely possible when combining the Wise Mind Nutrition app and weekly sessions with Dr. David Wiss or another member of the treatment team.

At Wise Mind Nutrition, we provide reliable virtual eating disorder treatment through our app, with the option of adding additional services. Individuals can choose to engage in the fully self-directed online program or decide to meet with a provider. With eating disorders, it is usually recommended to meet with a provider, as some nuances can be missed without one-on-one interaction, but whichever you choose, we look forward to being a part of your journey. Recovering from an eating disorder can be a process. We want to give you new coping skills and help you identify barriers to success. We are available to talk through different treatment options if you are ready to send an inquiry. While we specialize in nutrition, our real passion is recovery. I love helping people feel aligned with truth and liberated from diet culture. Together we can accomplish what we could never do alone.