Awareness of eating disorders has surged, and the treatment industry has been remade by private equity, virtual care, and consolidation. But for patients who need higher levels of care, the gap between recognition and real access remains stubbornly wide.
Key Takeaways
- Awareness has climbed sharply: eating disorder visits for children under 17 more than doubled between 2018 and 2022, and lifetime prevalence is now estimated at 9 percent or higher. The conditions are increasingly recognized as affecting people of every body size, age, gender, race, and income, not the narrow stereotype that long defined them.
- Access to higher levels of care has not kept pace. Roughly one in three people with an eating disorder ever seeks help, far fewer reach residential or partial-hospitalization care, and publicly insured patients and patients of color remain markedly less likely to receive guideline-recommended treatment.
- The industry delivering higher-acuity care has been reshaped by private equity and consolidation, leaving a handful of multi-site operators dominating the residential market. A wave of facility closures in 2023 and 2024 and pullbacks by major players have thinned the bed supply even as demand has risen.
- What has genuinely changed is the model, not just the marketing: virtual PHP and IOP have moved into the mainstream, and family-based, measurement-driven approaches have gained ground. New questions, from GLP-1 medications to softened parity enforcement, are now reshaping what payers will cover.
Eating disorders have had a moment, and by most cultural measures it has been a productive one. The old caricature, that these are illnesses of thin, affluent, white teenage girls who simply need to eat, has been steadily dismantled in the popular conversation. Providers now publish outcomes data showing that nearly half of their patients arrive at a normal weight or higher, that the great majority carry a co-occurring mental health diagnosis, and that recovery looks similar across body sizes. Awareness weeks draw corporate sponsors. Telehealth ads for eating disorder care fill social feeds. The language of body neutrality and weight-inclusive care has crossed over from clinical settings into ordinary speech.
And yet the question worth asking, two years into this moment, is whether any of it has reached the patients who need the most intensive help. The answer, uncomfortably, is mostly no. Recognition has outpaced access, the cultural conversation has outrun the supply of care, and for someone who needs a residential bed or a partial-hospitalization slot, the experience of trying to get one looks much as it did before the moment began.
Eating Disorder Prevalence Is Rising. Access to Higher Levels of Care Is Flat.
The epidemiological picture leaves little doubt that need is rising. Health visits for eating disorders among children under 17 more than doubled between 2018 and 2022, a surge researchers tie in part to the pandemic’s effect on adolescent mental health. Lifetime prevalence in the United States is now estimated in the range of 9 to 13 percent of the population, and eating disorders carry among the highest mortality rates of any psychiatric illness, with one analysis attributing more than 10,000 deaths a year to them, roughly one death every 52 minutes. The rising tide is not unique to eating disorders: across behavioral health, demand has climbed far faster than supply can meet it. The conditions are also being recognized in populations long overlooked, including people in larger bodies, men, older adults, and communities of color, where rates are comparable to or rising faster than in the groups that historically dominated the clinical literature.
Set against that need, the access numbers are sobering and have barely improved. By common estimates only about a third of people with an eating disorder ever seek professional help, and far fewer reach the specialized higher levels of care, residential treatment and partial hospitalization, that the most acute cases require. The disparities are sharpest where they tend to be: a retrospective study of youth found that roughly 40 percent did not receive the treatment recommended for them, and that having public insurance and being a patient of color each functioned as an independent barrier to getting guideline-concordant care. Eating disorders also remain chronically underfunded relative to their burden, a gap that has persisted even as awareness has climbed. The cultural moment, in other words, has changed how people talk about eating disorders far more than it has changed who can actually get treated for one.
Private Equity Remade Eating Disorder Treatment, Then Closures Thinned the Bed Supply
To understand why access has lagged, it helps to look at who now owns the higher-acuity system. Over the past decade, private equity transformed eating disorder treatment from a field of founder-led specialty centers into a consolidated industry dominated by a handful of multi-site operators. Eating Recovery Center changed hands repeatedly, reaching a reported $1.4 billion valuation in a 2021 sale. Monte Nido was acquired by Revelstoke Capital Partners in 2022 in a deal valued around $725 million, after earlier private equity owners helped it open and acquire dozens of facilities. The Emily Program and Veritas Collaborative merged under the parent company Accanto Health. By industry accounts, roughly five large companies now control most of the higher-level-of-care market, and the independent centers that once defined the field have become rare.
Consolidation promised scale, standardization, and the capital to expand access. In practice, the higher-acuity segment has proven difficult to run profitably. Eating disorders affect a comparatively small population, require long and clinically complex stays, and depend on contentious negotiations with commercial payers over how long a patient can remain at a given level of care. The result, beginning in 2023 and continuing through 2024, was a string of facility closures and pullbacks, with operators retreating from residential beds in some geographies and leadership turning over at the top of major companies. The fragile economics of behavioral health at scale came into sharp relief, and the bed supply, rather than expanding to meet documented demand, contracted in places. The patients squeezed hardest were often those with public insurance, since many marquee residential and PHP programs do not accept Medicaid or Medicare at all.
There are early signs of a turn. Industry analysts expected merger activity to warm again as macroeconomic conditions stabilized, and a notable recent twist has been addiction treatment providers expanding into eating disorders, drawn by the overlap in patient populations even as some traditional eating disorder operators retrenched. Whether that capital rebuilds higher-acuity capacity or simply reshuffles ownership is the open question for the next cycle.
What Actually Changed in Eating Disorder Care: Virtual PHP, GLP-1s, and Parity Rules
If access to a residential bed has not meaningfully improved, several real changes have nonetheless reshaped what eating disorder care looks like, and they are worth separating from the noise. The most consequential is the normalization of virtual higher-level care. Virtual PHP and IOP, once viewed as a stopgap, are now offered by most major operators across dozens of states, and survey data show broad public acceptance of virtual treatment as legitimate for eating disorders. Virtual care genuinely extends reach into rural and provider-scarce areas and lets patients practice recovery in their home environment. It is not a clean substitute for a residential bed for the most medically compromised patients, and some clinicians worry that a virtual-first system can leave the highest-acuity cases underserved while expanding access at the milder end. But it has changed the geography of who can be reached.
Two other shifts are reshaping the clinical and financial terrain. GLP-1 medications have introduced a genuinely new variable: the same drugs reshaping obesity care can trigger or mask disordered eating, and providers are simultaneously warning about that risk and exploring whether the medications might help patients with binge eating or bulimia. The field has not settled how to handle them, and payers are watching closely. Meanwhile, the policy backdrop for what insurers must cover has grown less certain. The administration announced in 2025 that it would not enforce strengthened federal mental health parity regulations, part of a broader parity enforcement rollback that matters acutely for eating disorders, where the fight over coverage has always centered on whether insurers will authorize enough days at the right level of care. Even where enforcement exists, it can be toothless: Georgia announced $25 million in parity fines in January 2026, and months later none of it had been collected. Parity has been the single most important lever for higher-acuity access, and softer enforcement points the wrong way for patients trying to get residential or PHP stays approved.
So has care actually changed? The model has, in ways that are real and largely positive: more virtual options, more measurement-based and family-based treatment, a broader and more accurate understanding of who develops these illnesses. What has not changed is the hard part. For a patient who needs residential or partial-hospitalization care, especially one on public insurance or living outside a major metro, the path to a bed remains narrow, the supply has, if anything thinned, and the financing is more precarious than it was when the moment began. The cultural conversation has done important work in reducing stigma and widening recognition. The harder, less photogenic work, building and funding enough higher-acuity capacity to match the need it has surfaced, is the part that still has not happened.
