Learn more about Equip treatment

For Providers
Addressing eating disorders in your patients
Tools for spotting signs, patient discussions, medical workups, and more
Are eating disorders hiding in your office?
What to look for when identifying an eating disorder
  • Rapid weight loss or gain, or failure to gain weight or height according to growth curve
  • Vital signs suggesting medical instability
  • Bradycardia
  • Alopecia
  • Cold or bluish extremities
  • Enamel erosion or enlarged parotid glands (signs of purging behavior)
  • Lanugo
  • Russell’s sign (calluses on the knuckles or back of the hand from purging)
  • Decreased bowel sounds or palpable stool
  • Abdominal pain and/or constipation
  • Fainting, fatigue, or dehydration
  • Injuries from overexercise
Why Equip is different
What to do if you’re concerned about a patientEarly intervention is critical for eating disorders. Symptoms can often be more severe than they initially appear.  
Start with curiosity when addressing any weight changes — making sure to never blame or shame the patient. For example, ask, “I’ve noticed your weight has changed. Can you tell me what’s been happening?” Use a HAES approach and consider additional health markers to assess the situation.
If you're worried about a patient but aren’t sure if it’s an eating disorder, it’s helpful to refer them to an assessment with experts. Equip offers a free online screener and consultations.
If you’re able to make a diagnosis or are concerned your patient may meet the criteria, it’s time to refer them to specialized treatment. Here’s Equip’s HIPAA-compliant referral form. You can also email refer@equip.health, call (855) 460-0516, or use EHR direct messaging.
Learn more about our treatment approach
For Providers
Medical evaluation guide
Follow these steps to perform a full medical workup for patients who may have an eating disorder.
Have your patient stand backward on the scaleWeight numbers can be triggering for patients with eating disorders. 
Avoid sharing weight number with your patientInstead, discuss general trends: up, down, stable. A height should be obtained to calculate BMI.
Consider weighing your patient in a gownSometimes, patients with eating disorders may attempt to manipulate their weight by wearing heavy clothing, hiding weights on their body, or drinking a lot of water beforehand. If this is a concern, weigh patients in a gown and consider testing their urine (if it is very dilute, they might be water loading).
When your patient might need to be admitted to the hospital
We follow the American Psychiatric Association Practice Guidelines and the Society for Adolescent Health and Medicine factors to support hospitalization to determine if a patient may need to be hospitalized for medical stabilization.
BradycardiaHeart rate < 50 beats per minute (daytime) or <45 beats per minute (with sleep)
Orthostatic hypotensionOrthostatic changes in pulse (sustained increase in HR >30 bpm in adults aged >19 years or >40 bpm in adolescents aged <19 years) or sustained decrease of blood pressure (>20 mm Hg systolic or >10 mm Hg diastolic).
HypotensionBlood pressure < 90/45
Severely low body weightLess than 75 percent of the median BMI for age, losing a large percentage of body weight rapidly, or precipitous fall off their growth chart line
Electrolyte deficienciesPotassium <3.5, Phosphorus <3.0, Magnesium <1.8
Prolonged QTc on EKGHeart rate < 50 beats per minute (daytime) or <45 beats per minute (with sleep)
Refer a patient
Use our HIPAA-compliant online form.
93%
of surveyed providers are likely to recommend Equip
Learn more about eating disordersIf you’re looking to grow your understanding of eating disorders, we have several resources that can help. 
Equip Academy
Join our virtual learning series, offering free CE/CME credits
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Frequently Asked QuestionsWe know how difficult it can be to find treatment that works, is affordable, and fits the needs of your patient and their family. We’ve done our best to answer family and providers’ most frequent questions so that you can be informed and confident in your choice. If you still have questions, please reach out to us.

We tailor treatment to each patient’s unique needs by using a variety of evidence-based treatment approaches.

Here’s a simple breakdown of the evidence-based approaches we most frequently use:

  • Family-based treatment (FBT): FBT is based on the idea that family members are best suited to help their loved one recover. Research shows that for children and adolescents with eating disorders, FBT has the highest rates of recovery and the lowest rates of relapse.
  • Enhanced cognitive behavioral therapy (CBT-E): CBT-E focuses on challenging unhelpful thoughts, beliefs, and attitudes that keep an eating disorder going.
  • Cognitive behavioral therapy for ARFID (CBT-AR): CBT-AR uses personalized strategies to address patients' unique ARFID symptoms, including sensory sensitivities, food-related fears, and lack of interest or poor appetite.
  • Dialectical behavioral therapy (DBT): DBT provides tools to help people regulate and cope with difficult emotions.
  • Temperament-based therapy with supports (TBT-S): TBT-S helps patients understand how their temperament traits (e.g. perfectionism, impulsivity, and determination) may contribute to their eating disorder symptoms, and how they can channel these traits into building a life outside of the eating disorder.
  • Exposure and response prevention (ERP): ERP focuses on helping people face their fears and triggers. These may include specific fear foods or social situations that contribute to eating disorder behaviors.

You can learn more about Equip’s treatment approaches here.

The key to FBT is caregiver and family involvement throughout the recovery journey. We encourage families to bring anyone who would be important for creating a recovery-supporting environment for the patient. Due to the virtual nature of our treatment, Equip can accommodate any family configuration, whether that means a single-family home, divorced families, chosen family with non-biological loved ones, and anything in between. We provide a level of care and support that’s truly tailored to each family in a way that’s often logistically impossible in brick-and-mortar settings.

Initial signs of an eating disorder may include changing eating habits, cutting out food groups, and skipping meals. In general, if you’re concerned about a patient it’s best to refer them to an eating disorder program for a free assessment. Early intervention carries a better prognosis for eating disorder recovery, so the earlier a patient can be diagnosed and begin treatment, the better. You can learn more about when to refer a patient here.

We treat patients of all ages and all eating disorder diagnoses in all 50 states. Our providers are trained to treat patients with all types and subtypes of eating disorders in the DSM, including anorexia, ARFID, bulimia, binge eating disorder (BED), and OSFED, and we also treat patients without an official eating disorder diagnosis.

Many of our patients experience comorbidities, and our clinicians are trained in treating these alongside the eating disorder. In fact, the majority of our patients present with one or more comorbid conditions, which are addressed over the course of treatment.

Equip redefines the fragmented eating disorder treatment landscape, offering evidence-based treatment throughout a patient's entire journey to recovery. Rather than segmenting patient treatment by acuity level (requiring step-down from one setting to another), Equip provides integrated, flexible treatment that meets patients where they are. As long as patients are medically stable, we can begin treatment. Learn more about Equip's level of care here.

No. Patients 18 and older can enroll in Equip treatment without family members, though we strongly recommend that they not go through treatment alone. Eating disorder recovery is hard, and the ongoing support of loved ones can be key to helping someone stick it out, adhere to their treatment plan, and avoid relapse. We recognize that for some patients, bringing additional people into the process may not be possible or supportive for a variety of reasons.

Patients have no limitations when it comes to who they can include in their treatment. They can bring in family if they like—parents, siblings, spouses, kids—but they can also bring in friends and other chosen family. Some patients might choose to include colleagues, coaches, faith leaders, or other important people in their life. We help patients build their support network and do the work of bringing them into the treatment process.

As long as patients are medically stable, we can begin treatment. For patients who are medically vulnerable, we require an in-person medical clearance exam before beginning treatment at Equip. This typically involves a visit to their primary care provider for a physical exam and to check weight, height, orthostatic vitals, and/or labs.

After they are medically cleared (using the criteria from the American Psychiatric Association Practice and the Society for Adolescent Health and Medicine), we continue to monitor medical status during their time at Equip, either through virtual medical monitoring or by collaborating with in-person medical providers, depending on a patient's needs. By closely tracking weight, vitals, and other markers as necessary, we're able to ensure that all patients can safely be treated at home. Visit our provider resource center for more details on how to medically evaluate a patient for eating disorder treatment.

Length of treatment varies from patient to patient, but the average patient in remission discharges after 51 weeks. This may sound long, but the length of treatment is specifically designed to prevent relapse, which is so common for these illnesses. Additionally, since patients go through treatment from home, treatment doesn’t impede their lives or the lives of their loved ones, and many of our insurance partners provide coverage for at least a year.

Generally, treatment begins as a high-touch process with several appointments per week, and gradually becomes a lower-touch experience as each patient moves through their treatment journey and toward recovery.

During the intake appointment with their Equip dietitian, patients and their supports receive a personalized recommendation around weight goals and monitoring. For young patients who need to gain weight, this generally means twice-weekly closed weights (formerly known as blind weights) at home. For adult patients, the decision to do open or closed weighing is decided on an individual basis, taking into account their treatment plan and preferences. All adult patients have the option of receiving a BodyTrace scale which enables at-home weight measuring without seeing the numbers, and sends data directly and discreetly to the patient's care team.

While weights are shared openly with parents and caregivers, we work with families to make a collaborative decision about whether it would be constructive to share weight numbers with younger patients. We also create a plan to handle potential responses triggered by doing so.

We do. Equip values the work referring providers have done with their patients and aims to support as seamless of a transition into our care as possible. Equip will coordinate how best to work together moving forward. For ongoing primary care providers, this may mean obtaining in-person vitals, weights, or labs when necessary. Our clinical team will also update primary care providers at key milestones throughout treatment, and inform them if there is a significant clinical change.

Equip also provides a live nurses line that referring providers can utilize at any time for care collaboration regarding their patients at Equip.