How to choose excellent eating disorder treatment in the USA
There are some good guides to help you find good specialist treatment for someone with an eating disorder in the US, and how to navigate the insurance system.
Here they are:
Port in a Storm: A F.E.A.S.T. family guide to eating disorder treatment – How to choose a treatment team for a loved one with an eating disorder in the US. Here.
Is Your Eating Disorder “Specialist” Really a Specialist? An article by eating-disorder therapists Alli Spotts-De Lazzer and Lauren Muhlheim. Here.
More on insurance further down.
If you can't get a good eating disorder treatment team locally
Often you just don't have access to any good outpatient treatment close by (but your insurance provider may help you find one — see further down). Even if there's an excellent therapist near you, they may have a long waiting list. You want to avoid doing nothing while you wait — early intervention is crucial.
Nowadays there is a lot more telemedicine available, luckily. You don't even need to choose someone in the US — it can be someone anywhere in the world. In the US, note that for insurance reasons, a professional from one state may only be allowed to provide telecare in some other states.
Choosing a certified FBT therapist gives you some level of trust that you've got someone trained and supervised at a high level. I list those I know do treat by video call here.
American standards for treatment
Have a look at The American Psychiatric Association Practice Guideline for the Treatment of Patients with Eating Disorders (2023)
It's easy to read, very clear, and totally in line with the best recommendations elsewhere in the world. You should expect your child to be treated in accordance with this Guideline.
There's also fantastic standards and guidance in:
Academy for Eating Disorders guides: the one for Medical Care and the one for Nutrition Treatment
Also Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults, The Society for Adolescent Health and Medicine (SAHM), J Adolesc Health 71(2022)
The 504 Plan: your school's obligation
In many countries, there is legislation to ensure schools will support students with a disability and will remove barriers to learning. In the US, this is the 504 plan. Read more, for instance here.
Medical Insurance in the US
A US mother kindly shared these tips (in 2026):
One of the hardest parts of caring for a child with an eating disorder is navigating the health insurance system. It can feel overwhelming at first, but learning how your benefits work can make a tremendous difference—both financially and in accessing the right care. Every insurance plan is different, but here are some strategies that helped our family and may help yours:
Ask for help finding eating disorder specialists
Don't rely only on your insurer's online directory. Call and ask to speak with a care coordinator or case manager who can search for eating disorder specialists in your area. Provider directories are often outdated, and representatives sometimes have access to newer information or providers who are not yet listed online.
Request a network gap exception if necessary
If you cannot find an in-network eating disorder specialist within a reasonable distance or timeframe, but you have found out-of-network ones, ask your insurer about a network gap exception or single-case agreement.
Depending on your plan and state regulations, this may allow you to receive care from an out-of-network specialist while paying in-network rates.
Ask for a dedicated case manager
If your insurer offers case management, take advantage of it. We called regularly until we were assigned a case manager, and that person became an invaluable advocate.
They helped coordinate benefits, reviewed previously processed claims, answered questions, and identified opportunities for additional reimbursement. In our case, several claims were successfully reprocessed, and we even received reimbursement for some out-of-network providers.
Make sure all bills are coded with the documented diagnosis
Ensure all medically documented diagnoses are included—not only the eating disorder diagnosis but also complications such as bradycardia, orthostatic hypotension, malnutrition, dehydration, amenorrhea (when applicable), electrolyte abnormalities, stunted growth or failure to thrive in younger patients.
This ensures the insurance is treating ED as a mental AND physical disorder which usually brings higher coverage rates.
Know all your benefits
Enteral Nutrition coverage:
We consumed thousands of dollars per year in high calorie shakes. Some insurance plans cover medically necessary oral nutritional supplements or enteral nutrition when prescribed by a physician and supported with documentation of medical necessity (letter with diagnosis code, product name). Note that you may need to buy them from specialized medical supply stores (online) vs. retailers like Amazon or your local grocery.
Dermatology Care – Acne Surgery:
Our child ended up with grade 4 acne all over his face once his nutrition got back on track. He had severe scarring and pigmentation. We worked with the insurance to identify a provider to do acne surgery (extractions) with medical necessity letter, diagnosis codes, provider tax ID, and national provider identifier number.
Mental Wellness resources:
Our insurance offered free subscription to an excellent meditation app which helped our entire family.