Treatment Centers for Eating Disorders: How Effective Are They?

Having worked as a therapist/counselor in the eating disorders field for many years, I'm not convinced that treatment centers affect much recovery--not because the treatment centers are ineffective or staff are not competent, but because the patients themselves are generally not willing to change. Most people with eating disorders, such as anorexia, bulimia, and, sometimes, binge-eating disorder, who admit themselves into either eating disorders hospitals or treatment centers do not want to change; that is, they do not want to stop their eating disorder behavior.
I have seen parents and spouses make deals with their loved ones to attempt to get them into a recovery center--a new car, a hefty allowance, exotic vacations, or paid-for college tuitions.
Most people with eating disorders who go to hospitals or treatment centers, many of whom are under 30 years old, are in the precontemplation stage (Prochoska, DiClemente, and Norcross, 1994) which simply means they are either in denial of their problem or have absolutely no intention of changing. My clinical experience suggests that only those people who are either in the contemplation stage (meaning that they know they have a problem, how it may be affecting them, and want to explore options for recovery) or action stage (meaning they are actively engaged in, serious, and honest about the recovery process) have any real hope of affecting much change within the context of a treatment hospital or center. A few individuals transition from the precontemplation to contemplation or contemplation to action stages while they are in treatment but, in my experience, this is the exception rather than the rule.
Even in individual therapy, research indicates that it is the patient's attitude that truly effects change--not the training of or modality used by the therapist. Treatment centers or eating disorders hospitals do provide containment and care for patients who might otherwise die. Unfortunately, many patients return to their old ways shortly after being discharged from the treatment center.
When all is said and done, the truth is that one cannot will or force recovery on another individual. The individual must be willing to change; they must be willing to accept that their eating disorder obsessions (thinking) and compulsions (behavior) have been self-destructive and they must come to an understanding of the seriousness of the disorder. Only then, I am convinced, can one be saved from the ravages of these insidious eating disorders.

Note: For more information on the five stages of change (two of which were not discussed in this brief essay) proposed by Prochaska, DiClemente, and Norcross, please see the reference below. I have found that, indeed, there are stages of recovery and the authors' stages seem to correlate well with the different levels of unwilliness and willingness to change addictive behaviors.

References:
Prochaska, J.O., DiClemente, J. O., & Norcross, C. C. (1994). Changing for good. New York: Avon Books.