13
Table 5. Considerations in Determining an Appropriate
Level of Care
• Factors that suggest significant medical instability, which may require
hospitalization for acute medical stabilization, including need for
monitoring, fluid management (including intravenous fluids), electrolyte
replacement, or nutritional supplementation via nasogastric tube feeding
(see Table 6)
• Factors that suggest a need for inpatient psychiatric treatment (e.g.,
significant suicide risk, aggressive behaviors, impaired safety due to
psychosis/self-harm, need for treatment over objection or involuntary
treatment)
• Co-occurring conditions (e.g., diabetes, substance use disorders) that would
significantly affect treatment needs and require a higher level of care.
• Lack of response or deterioration in patient's condition in individuals
receiving outpatient treatment
• Extent to which the patient is able to decrease or stop eating disorder and
weight control behaviors (e.g., dietary restriction, binge eating, purging,
excessive exercise) without meal support or monitoring
• Level of motivation to recover, including insight, cooperation with
treatment, and willingness to engage in behavior change
• Psychosocial context, including level of environmental and psychosocial
stress and ability to access support systems
• Extent to which a patient's access to a level of care is influenced by
logistical factors (e.g., geographical considerations; financial or insurance
considerations; access to transportation or housing; school, work, or
childcare needs)
