Our April post on the changing landscape of mental health support during COVID feels like a lifetime ago. Many of those in the eating disorder recovery community were exploring online support groups, telemedicine and telehealth for the first time. Fast forward to today, and many of these relatively unfamiliar forms of programming have become a new standard and a common practice.

Telehealth enables those who are struggling with eating disorders an opportunity to connect remotely with clinicians to receive services virtually. Secure software protects patient privacy, while still providing the opportunity to communicate over video, “face to face” with a doctor, nurse or a therapist. As we continue to practice social distancing and adhere to local and state guidelines, telehealth offers a crucial avenue to continuing the eating disorder recovery journey, even when in-person programming isn’t an option.

At Reasons, we have learned so much during this time about the benefits and challenges associated with a telehealth program. For those considering virtual eating disorder treatment options, and for providers exploring offering this type of programming, we wanted to share a few things we’ve learned along the way:

Challenges and Underlying Opportunities

“Zoom Fatigue”

The concept of “Zoom fatigue,” the draining nature of long periods of video conferencing, is real. While the term was coined off of a popular video conferencing platform, it applies equally to secure and HIPAA-compliant video programming, too. Online video conferencing can require a lot of different parts of our brain to fire at the same time. We might need to look at a person on camera, look at content on a screen, absorb information, and check chat channels all at the same time. And that’s just the tip of the iceberg! If your video conferencing is running while you’re also attending to emails and receiving other notifications on your streaming device, your brain will be working in overdrive to consume all the information you’re receiving. Compound this challenge with how much screen time many of our jobs require, and the challenge mounts even further. For these reasons, we encourage telehealth patients to turn off notifications and other devices, and we do not use on-screen presenting during a session. Instead, we focus on connecting face-to-face over video, so the clinician and the patient can be as present as possible.

Self on Screen

For those working toward eating disorder recovery, mirrors often present a significant challenge. Imagine the challenge of seeing one’s self unavoidably on a video screen. At Reasons, we try to frame this challenge as an opportunity and as exposure therapy. Together, we explore with patients how they might re-frame their assessment and feelings around the self they see on screen.


Eating disorder recovery programming is highly personal in nature. With the exception of group therapy sessions, many therapeutic interventions are one-to-one, private interactions. In the world of telehealth and video conferencing, finding physical space to have a private conversation can be difficult. We encourage patients to seek out a secluded spot where they feel safe, uninterrupted and unheard.

Vitals Monitoring

Since eating disorders are mental health issues with direct impacts on the physical body, vitals monitoring is a key component of treatment. Eating disorders can be physically life-threatening, so it is crucial to understand a patient’s physical wellness. For treatment providers, consider working with an outpatient team to determine the necessary frequency of vitals checks, or opening your space weekly for in-person monitoring visits if it is safe to do so.

Longing for In-Person Connection

Whether you’re in eating disorder treatment or not, social distancing has highlighted for many people the longing for in-person connection. Often, video doesn’t feel like enough, especially for those who place a high value on body language, eye-contact, and non-verbal cues.

For the ED patient, seeing oneself in the Zoom window is tough. Spin – it is exposure therapy!

Telehealth Benefits

Despite the challenges associated with virtual eating disorder treatment programming, telehealth also offers unique benefits for the patient and the provider.

Increased Access to Care

For those with transportation challenges, telehealth opens a new door to receiving treatment. If you do not have a means to reach a treatment center for in-person sessions, you can instead gain the value of those sessions from the comfort of your own home. Furthermore, for those who struggle to balance the time commitments of commuting, telehealth offers the breathing space to avoid trekking to and from treatment to work to home.

Increased Insurance Coverage

In some instances, insurance providers will offer greater coverage for telehealth than for in-person programming. Insurance protocols vary widely by provider. Check with your insurer or reach out to your telehealth provider for guidance on navigating the system.

Eases Anxiety

Many people feel anxious about opening up in a group setting, especially on a topic as personal as eating disorder recovery. Beyond the anxiety of showing up in a group setting, others feel nervous stepping into healthcare environments. For these individuals, telehealth can offer a way of pursuing treatment with a greater sense of ease.

An Answer for Ambivalence

Many people who struggle with eating disorders express ambivalence or denial about the need for treatment. For those who aren’t sure if eating disorder treatment is right for them, virtual programming can provide a low-pressure way of exploring treatment without feeling heavily committed to longer-term programming.

Creates a New Kind of Community

Telehealth widens the radius of who can realistically participate in eating disorder treatment programming. The typical in-person logistics of commute, travel and lodging disappear in the context of telehealth. This not only opens the door for more people to receive much-needed treatment. It also widens and diversifies the community of patients who participate. As a patient, telehealth increases the likelihood that your recovery community spans the country and offers you a new way of broadening your horizons and networks.

Undoubtedly, the pandemic has created many twists and turns in life for all of us. In the context of our programming at Reasons, we’ve certainly had to get creative! But, we are grateful for that opportunity. As a recovery community, we have learned so much this year about the highs and lows of connecting in a virtual world. We are committed to sharing what we learn and to evolving and growing, right alongside our patients.

If you or someone you know is struggling with an eating disorder, do not let physical proximity to treatment stand in the way of help. Whether through Reasons, or another provider you trust, virtual programming may open the door to your recovery journey, or at least provide a dose of virtual support along the way.