Eating Disorders News

Information on eating disorders and how to cope with them

An Alternative to Leaving College for Treatment

Duke University experiments with a new intensive eating disorders program

For those of you who are college students now, or have family members or loved ones who are, here’s a promising new form of eating disorders treatment.

In response to the large number of students with severe eating disorders seen at the Duke University student counseling center, Duke Health System and the School of Medicine at Duke have just launched an intensive evening treatment program.

The idea is to try to help students get their disorder under control without having to leave school.

Nancy L. Zucker, PhD, director of the Duke Center for Eating Disorders, explains that some of the alternate forms of care that students could be referred to are intensive outpatient treatment, partial day treatment, or inpatient treatment. Opting for some of these, however, would mean taking a leave from school when not all students need this level of care. Dr. Zucker and her colleagues wanted to offer these students “a trial period” of more intensive outpatient treatment than they would get at the counseling center, yet that allowed them to graduate on time.

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The other motivation for this experimental approach is that clinical observation shows that not every student is ready, psychologically and motivationally, for the level of care that is most appropriate for her or him. In some cases, the fear of hospitalization prevents a student from seeking much-needed treatment. So Dr. Zucker and her colleagues want to know: Is some treatment better than none? Can patients improve under such conditions? Can an intensive outpatient treatment program serve as a “motivational gateway,” giving students the chance to accept and embrace the need for and the challenge of stepped-up care?

These are questions that Dr. Zucker hopes the new intensive evening treatment program will answer. The three-session program takes place Monday, Tuesday, and Thursday evenings in a single week. Each three-hour session includes a guided meal, music group, and mindful movement sessions. The first session is devoted to helping patients figure out what it is that the eating disorders is giving them (escape, relief from negative thoughts about oneself), and how it is alienating them from what gives their lives meaning (goals, friendships). The second session helps patients listen to “body messages,” to reclaim the body’s natural ability to respond to cues such as hunger or satiety—skills that an eating disorder typically bullies into submission. The final day three zeros in on relationships, communication, and assertiveness, tools the patient needs to rebalance a life that may be too centered on people-pleasing and the sublimation of her or his own needs.

Out of 72 students evaluated for eating disorders last year at the student counseling center, 20 were referred to the Duke Center for Eating Disorders, and Dr. Zucker estimates that between four and five students left school to seek a higher level of eating disorder treatment.

“Colleges around the country are all desperately trying to come up with solutions to manage eating disorders on college campuses and to ensure that students get the level of support they need,” notes Dr. Zucker. Stay tuned, we’ll follow up with her at the end of this academic year to find how effective this particular program’s first year was at doing that.

Nancy Matsumoto is a freelance journalist who has written numerous stories on health, eating disorders, and body image.

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