 
Eating Disorders Program
Program life
The Menninger Clinic strives to offer a treatment experience that differs from a traditional hospital and helps the patient take full advantage of treatment.
Where patients reside
The Eating Disorders Program is located in a large one-story building—one of seven buildings on the 14-acre campus shaded by tall pines—with two other programs. The patient living buildings are much like a university residence hall with patient rooms up and down the hallway. The programs are co-ed, but roommates are the same gender.
Spacious common areas with sofas and tables, both large and small, anchor the halls. Rooms where groups meet, nursing stations with an open doorway, TV/game areas, a kitchen-snack room and laundry room round out the Program’s space.
On the campus, lawn chairs, gazebos, a pool, a full-size gymnasium, tennis courts, walking trail along with the sounds and sights of a backyard await patients during their unscheduled time.
Atmosphere on the unit
Staff dress in business and business casual attire. Patients are encouraged to dress comfortably. Appropriate attire is required on the unit at all times.
Most of the treatment team offices are located in the building with the unit. As a result, members of the entire treatment team interact with patients both formally in treatment and informally throughout the day. Nursing staff are available on the unit around the clock when patients have questions or need support.
The patients and staff function together as a community. The patient community plays a vital part in the milieu. Patients meet weekly in a community meeting. This meeting provides a forum to welcome new patients and staff, say goodbye to those leaving and to discuss issues of interest to the patients. Each day patients and staff meet to plan the activities for evenings and for trips into the community.
The unit is left unlocked unless the staff or patient community determines that locking the unit is best for the safety of one of the patients and the patient community.
Bathrooms are often a place where eating disorder symptoms occur. Bathrooms are locked at all times unless purging is not a behavior issue for the patient. The opportunity to use the bathroom is provided before breakfast for showering and grooming, as well as 10 to 15 minutes before meals. Staff will be available to unlock and monitor the bathroom as needed. The goal is to discontinue bathroom monitoring before the patient is discharged.
First days in the program
- With an Admissions coordinator, the patient and family complete the admissions paperwork.
- Members of the treatment team greet the patient and family on the unit.
- The staff inventories and checks the patient’s personal belongings to ensure the safety for all patients.
- The patient moves into his/her room. Rooms are set up for double occupancy. Each offers an in-room bathroom with tub/shower, individual desks, a closet and a window. A handicapped accessible room is also available. The adolescent and adult Eating Disorders Programs are co-ed programs. Roommates are the same gender. Patients socialize in the common areas and not in one another’s rooms.
- A staff psychiatrist and an internal medicine physician see the patient within 24 hours of admission.
- Staff introduce the patient to other staff and patients, and orient them to the program within the first few hours of admission.
- The treatment team and patient work together to stabilize symptoms and begin assessments that help the team better understand the patient and his/her needs. During these days, the patient may participate in a shortened version of the core programming. The treatment team and patient collaborate on goals for treatment, and a treatment plan is set.
Upon admission, the patient is asked to agree to sign the eating disorders contract. The contract states that the patient is committed to participating in treatment and to:
- Eat all foods that will be prescribed (except three disliked foods the patient names that won’t be served while at Menninger),
- Abstain from any use of laxatives, diuretics, stimulants or any medicine not prescribed by a physician,
- Comply with all of the policies of the Eating Disorders Programs and
- Be honest when you are having difficulty with any part of the program.
The patient's pouse/partner or other immediate family member should plan to stay at Menninger a full half day beginning at admission. The family meets with the primary clinician, program psychiatrist and the program director. These meetings allow the staff to gather information for the assessments and begin family therapy right away. An initial schedule for family therapy and psychoeducation is established before the family leaves.
Mealtime
Food will be prescribed as medicine to meet the nutritional needs of the patient. Meals are designed to renourish and fuel the body, as well as foster healthy eating. At the time of admission, the patient may choose three specific disliked foods. These foods will not be offered during the stay in the hospital. Meals will be planned by the dietitian during the initial stages of treatment.
Because many patients have mixed feelings about getting well, the Menninger team believes it is helpful to associate positive rewards with healthy behaviors. For this reason, the patient earns the privilege of choosing menus after eating 100 percent of six consecutive meals. The number of calories is determined by the dietitian at a level to help the patient normalize food intake gradually with the goal of improving nutritional status. It is not the programs’ policy to force calories for the purpose of rapid weight gain.
Meals are served at 8 am, Noon and 5 pm to be eaten as they are served. Patients dine together on the unit for at least the first week. Then patients will eat together with staff supervision in The Clinic’s main dining room. As the patient begins to regain control of eating, she/he will receive more independence in selecting menu choices. Twice a week, the dietitian will meet with the patient for personalized nutritional counseling.
As treatment progresses, the patient will work toward independent dining in the Menninger cafeteria without being accompanied by staff or patients from the Eating Disorders Program. The patient will also have opportunities to order off the menu from about a half dozen restaurants and to cook for herself/himself.
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