Treatment of Eating Disorders in an Outpatient Center; When to Refer to a Higher Level of Care

The severity of a client’s eating disorder may require a more intensive level of care than

can be provided by outpatient programs. Referral to a higher level of care is typically warranted based on at least one the following:

• Chronic physiological signs (based on one or more of the following):

1. heart rate <40 bpm
2. blood pressure <90/60mm Hg
3. glucose <60mg/dl
4. potassium <3 meq/liter
5. electrolyte imbalance
6. temperature <96.0 degrees F
7. dehydration
8. hepatic, renal or cardiovascular organ compromise requiring acute treatment

• Inability to maintain a BMI of at least 18
• Inability to “break the cycle” of chronic eating disorder behavior
• Inability to engage in effective outpatient therapy

Adapted from University of Notre Dame