The eating disorder treatment challenges landscape is facing significant difficulties as providers work to meet the needs of a patient population that continues to grow, despite the struggles inherent to the field. During a recent Behavioral Health Business INVEST panel in Dallas, industry leaders Abhilash Patel, CEO and co-founder of Within Health, and Thomas Britton, CEO of Accanto Health, openly discussed the current state of the industry. They were joined by Haywood Miller, a managing director at BRG advising on mergers and acquisitions, to share their perspectives on how the sector is evolving amid challenges such as attracting patients, workforce shortages, and industry consolidation.
The discussion revolved around the hurdles that eating disorder treatment providers are grappling with, as well as the future direction of the industry. Patel, whose company offers telehealth services to individuals struggling with eating disorders, painted a picture of a market that is experiencing growing pains. “There will be contractions before there is consolidation and expansion,” Patel said, reflecting on the unpredictable nature of the industry. This sentiment points to a crucial juncture in eating disorder care—one that follows a period of significant growth. Investment and deal-making among eating disorder providers peaked in 2021, but as Miller pointed out, this trend has cooled considerably.
The cooling down of investments and high-profile retrenchments in the industry signal deeper issues. Last year, well-known private equity-backed companies such as Odyssey Behavioral Health and Discovery Behavioral Health announced the closure of several residential treatment facilities. Early this year, another major player, Optum subsidiary Refresh Mental Health, shut down its eating disorder service line altogether. These retrenchments are clear signs of the strain the sector is facing, and as Britton pointed out, the surge in investments during the previous years wasn’t necessarily due to a breakthrough in treatment but rather consolidation among providers.
While the financial turbulence and closures are worrying, there remains significant demand for treatment. Statistics from the National Eating Disorder Association reveal that about 28.8 million Americans will experience an eating disorder at some point in their lives. Yet, despite the large pool of potential patients, the eating disorder treatment challenges persist, with the field remaining smaller compared to other behavioral health issues, such as substance use disorder (SUD). According to Britton, who previously served as the CEO of American Addiction Centers, the U.S. has a patient population of 30 to 60 million people who need SUD treatment at any given time. In contrast, eating disorders affect a much smaller pool of people, with estimates ranging from 3 million to 8 million individuals requiring care.
The relatively smaller patient pool makes attracting and retaining patients an ongoing challenge for eating disorder providers. Britton highlighted the stigma that continues to surround eating disorders, noting that many individuals with eating disorders may be reluctant to seek help due to shame or fear of judgment. This challenge is similar to what providers in the SUD field experienced over a decade ago, according to Patel. He pointed out that widespread investment in SUD clinics only gained traction once more people felt comfortable addressing their substance use issues openly. The stigma around eating disorders, Patel suggested, has similarly contributed to the slow uptake of treatment, but as society’s awareness and attitudes shift, more people will likely feel empowered to seek help.
Patel’s perspective on stigma took a personal turn, with the Los Angeles-based CEO reflecting on the normalization of disordered eating in his community. “I live in Los Angeles,” he said, “I can’t throw a rock without hitting somebody where you’re like, man, this person has disordered eating.” While the de-stigmatization of eating disorders is still in progress, Patel believes that the rise of awareness and the increasing willingness to speak out will drive more demand for services in the years to come. This shift could lead to fewer eating disorder treatment challenges as more individuals reach out for help and support.
But even as the patient pool grows, providers face significant workforce challenges. Both Britton and Patel expressed difficulty in recruiting clinicians who possess the specialized expertise necessary for treating eating disorders. Patel emphasized that eating disorder treatment requires a unique blend of medical and psychological knowledge. It’s not just about addressing behavioral health; it also involves understanding the intricate medical aspects of conditions like anorexia, bulimia, and binge eating disorder. Recruiting staff with this specialized skill set is a constant challenge, especially given the shortage of clinicians across the broader behavioral health field. These eating disorder treatment challenges are compounded by the need for experts who can combine traditional care with specialized treatment methods.
The discussion also explored the ongoing debate between telehealth and residential treatment. While Patel champions the benefits of telehealth, believing that virtual care can offer a high level of treatment remotely, Britton provided a counterpoint. At Accanto Health, around 20% of patients are in need of intensive, hospital-level care. For these individuals, residential programs may still be necessary, as they offer a level of care and supervision that virtual clinics cannot provide. However, Patel remains confident in the future of telehealth for eating disorder treatment, pointing out that virtual providers like Within Health can innovate in ways that traditional brick-and-mortar clinics might not be able to. “If someone’s the best at something, there will be room for that particular operator,” Patel asserted.
Despite differing views on telehealth, both leaders agreed that partnerships between physical and virtual providers offer promising opportunities. Patel emphasized that collaboration between various types of providers—whether in-person or virtual—will be crucial to delivering comprehensive care. “Operators have to work together to find people the care they need,” Patel said, noting the importance of a collegial approach in solving complex patient needs. These partnerships could help mitigate some of the eating disorder treatment challenges related to access and treatment gaps.
Looking toward the future, both Patel and Britton highlighted several emerging trends that could reshape the eating disorder treatment landscape. One potential game-changer is the use of wearable devices to monitor food consumption. Patel suggested that these devices could provide valuable insights into a patient’s eating patterns and help guide treatment. In addition, the use of medications like GLP-1s to manage binge eating could become more widespread, offering another layer of treatment for those struggling with food-related issues. Even more futuristic possibilities were discussed, including the potential role of psychedelics in treating eating disorders by altering patients’ perceptions and attitudes toward food.
“There’s all sorts of room for an open mind and figuring out what is actually going to work,” Patel concluded, pointing to the possibilities that lie ahead in a rapidly evolving field. As providers continue to explore innovative treatment options, they will likely find ways to reduce the eating disorder treatment challenges currently faced by the industry.
Despite the challenges and uncertainties that continue to shape the eating disorder treatment industry, it’s clear that there is room for innovation and growth. By embracing new technologies, expanding treatment options, and fostering collaboration among providers, the industry has the potential to evolve into a more effective and comprehensive system of care. As stigma continues to diminish and more individuals seek help, the demand for quality treatment will likely increase, pushing the sector toward a brighter, more inclusive future for those affected by eating disorders.
