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Your Recommendation
Based on your Level of Care Self-Assessment results, you may benefit from:
👉A program that offers outpatient eating disorder service that offers treatment for Avoidant Restrictive Food Intake Disorder (ARFID).
In addition to:
👉Emotion skills programming or Dialectic Behaviour Therapy (DBT)
Understanding Your Recommendation
For Treatment of Your Eating Disorder:
Based on your responses, we recommend you and your primary care provider consider a referral to an outpatient eating disorder service that offers treatment for Avoidant Restrictive Food Intake Disorder (ARFID). While this questionnaire cannot diagnose a particular eating disorder, your responses suggest you are describing symptoms that are part of ARFID. Not all eating disorder programs offer treatment for ARFID, so you and your physician will need to choose a program that does treat ARFID. Your responses suggest that an outpatient setting would be appropriate given your medical risk. Your eating disorder treatment team will make the final
recommendation concerning the type and intensity of treatment after you complete an assessment with them.
For Emotional Skills Programming or Dialectical Behaviour Therapy (DBT):
We recommend you and your primary care provider consider a referral to a DBT or emotion skills program as soon as possible. If you have made recent or frequent suicide attempts, or if your self-harm behaviours are frequent or medically risky, you will need treatment for these issues – for example by getting treatment for depression and/or doing DBT treatment. Your eating disorder treatment team will help you decide on the best plan for managing both your suicide or self-harm risk and your eating disorder.
If you have been recommended outpatient treatment for your eating disorder, we recommend that you and your physician seek a referral to a DBT or emotion skills program as soon as possible. If your self-harm or suicidal thoughts/behaviours are related to depression, you should work with your doctor to get help with your mood. Self-harm, suicidal thoughts/behaviours and depression can all interfere with treatment and recovery from an eating disorder. Once you are referred to and seen at the eating disorders outpatient clinic, your self-harm, suicidal thoughts or behaviours and depression will all be carefully assessed along with your eating disorder. The outpatient team will work with you to decide on the best treatment plan.
Dialectic Behaviour Therapy (DBT) Service Providers Available to Ontario Residents:
Dialectic Behaviour Therapy (DBT) Programs in Ontario (Covered by OHIP)
SCOPE: Additional Dialectic Behaviour Therapy (DBT) Resources
Virtual drop-in (low barrier) DBT group:
Contact dropindbt@stjosham.on.ca for referral and information. Meeting URLs sent through email upon referral and selection of date and time.
Working with Your Primary Care Provider
We encourage you to share your LoCSA results with your primary care provider. Your primary care provider plays an important role in helping you understand your care options, review medical considerations, and take the next step toward recovery. It can be scary to start this conversation. Usually, it’s best just to be direct: “I am worried about my eating and was hoping to talk with you about treatment options for an eating disorder”.
If you’ve never had a conversation with your primary care provider about your eating disorder or disordered eating concerns, we recommend you check out the resource below to help you prepare the information you might want to share with your primary care provider:
Follow-Up Questions:
Along with your LoCSA results, there are other important factors that can affect which care options may suit you best.
Here are some possible follow-up questions to ask your primary care provider:
“Will I need to take time off work or school for this type of care?”
“Are there local programs or virtual options available?”
“What happens if there is a long waitlist? What can I do while I wait?”
"I’m not sure I feel ready to recover or commit to this level of care — What supports can help me get started?””
“I’ve tried _____care before — what are my options if that wasn’t a good fit?”
Want to Talk Through Your Options First?
If you’d prefer to speak with someone about your care options before connecting with a primary care provider — or if your provider isn’t familiar with eating disorder supports — the National Eating Disorder Information Centre (NEDIC) can help.
Their trained support workers can listen, provide information, and guide you through available resources.
Live Chat: www.nedic.ca
Helpline: 1-866-NEDIC-20 (or 416-340-4156 in Toronto)
What if I Don’t Have a Primary Care Provider?
If you don't currently have a primary care provider (family doctor or nurse practitioner), Health Care Connect is a free program from the Ontario Ministry of Health that can help you find one.
Resources to Explore:
What You Can Do While Waiting for Treatment
Talk To Your Primary Care Provider About Medical Monitoring:
While you're waiting for treatment, it's important that your primary care provider is keeping track of your physical health. This medical monitoring can help keep you safe and supported.
To support your primary care provider in this process, we recommend sharing this resource with them:
Access Community Support:
Community-based support programs are not a replacement for eating disorder treatment, but they can play an important role in your recovery journey. These programs can help you prepare for treatment, support you as you transition back home afterwards, and offer a space to build a sense of community. You can also learn helpful coping strategies and tools to support your well-being along the way.
An example of this kind of support is offered by Body Brave, a Hamilton-based organization offering low-barrier, online eating disorder support.
Ways to Reduce Your Medical Risk
We understand that making the decision to get treatment for your eating disorder can be very anxiety-provoking. We want you to know that the people working in the eating disorder treatment programs across the province would really like to help you, and will explain what is involved in treatment so you can decide if it is right for you. Whether you decide to proceed with treatment or not (and we hope you do!), below are recommendations that can reduce the medical risk associated with an eating disorder. These recommendations are very unlikely to cause weight gain but can help ensure your body is safer and more medically stable.
Steps you can take to improve safety may include:
Follow any medical advice from your primary care provider (and be honest about your symptoms)
Increase food intake enough to stop further weight loss (see link below)
Use harm reduction strategies to reduce the risks associated with purging (see link below)
Decrease vomiting frequency to no more than once a day
Cut laxative use in half each week until eliminated
Reduce over-exercising (ideally to no more than one hour per day)
Eat three times a day — you can choose what and how much, as long as you’re eating consistently
Resources to Explore:
When to Seek Emergency Care
Eating disorders can cause serious medical complications. You should go to the emergency department if you experience:
Very slow, irregular, or racing heartbeat
Chest pain or pressure
Fainting or dizziness upon standing
Severe headache, confusion, or seizures
Severe muscle cramps or weakness
Vomiting blood or severe abdominal pain
Very little or very dark urine
Swelling in limbs
Suicidal thoughts or not feeling safe
For those with Type 1 Diabetes: High blood sugars associated with the presence of ketones; symptoms of DKA such as stomach pain, shortness of breath, feeling sick, feeling tired, sleepy or confused.
When in doubt, go to the emergency room. It's always better to be safe.
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