Why In-Person is Better than Virtual Treatment

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In-person treatment session at Kahn Center for Eating Disorders

There are two main reasons why we firmly believe that in-person treatment is superior to virtual treatment.

Because of our use of the Body Composition Analysis in the office, we can offer meal oversight approximating what someone would get in 24hr care. Let us explain further why this tool is useful in the IOP/PHP setting. 

Let’s assume that someone was a borderline case who could either be in a 24hr residential program or a PHP program. The upshot of 24hr care is that people are monitored 24hrs/day, and one can monitor every morsel eaten. It is practically impossible to skip meals. 

Advantages of PHP

At other PHP programs, they cannot cheat while they are in programming. However, they can cheat when they are not in programming. So there is no way to know if they wish to conceal it, whether they are eating breakfast or dinner – and there is lots of cheating going on. Virtual programming is easy to cheat, whether inside of programming or not.

One of the advantages of PHP treatment is that they are still living in their home environment. Individuals will learn to deal with triggers, including people, places, and things that can cause them to want to act out with eating disorder behaviors. Outpatient allows healing in the concrete environment where the eating disorder came to be and where they will continue to live. 

Disadvantages of Inpatient

The disadvantage of 24hr care is that they are in a complete bubble and removed from their natural environment. The return home from inpatient can be difficult because they cannot work through the actual things and people that contribute to them wanting to act out in eating disorder behaviors.

However, with the Body Composition Analysis, we can see immediately if they are not adhering to their meal plan. With body composition analysis, it is impossible to cheat and get away with it. The Kahm Center can offer close to the same kind of meal oversight that 24hr treatment can offer. 

Those struggling with eating disorders can get the best of both worlds. You will be able to address the problems in your actual environment and be provided meal support similar to an inpatient facility. This is one of the reasons why our program is so effective and unique, but it can only happen if they come in person.

In-Person Treatment Benefits

We firmly believe that sitting before someone, person-to-person, is better than screen-to-screen. Just as everyone knows that the COVID-mandated online schooling was bad for students, so is the case with group therapy, which is at the core of IOP and PHP treatment. 

Experiences lost in virtual treatment can include:

  • Body language
  • Vocal signals
  • Facial cues
  • Sitting and eating together

Meal support is virtually impossible to do with any real accountability virtually. We repeatedly hear this from our colleagues in the field and patients we have sent from our outpatient to other virtual programs.  In IOP and PHP treatment, in which much of the time is spent in group therapy and eating together communally, it is crucial that the members of the group form real relationships. 

Outpatient Eating Disorder Treatment in Vermont 

It’s nearly impossible to get to know complete strangers when you’re virtual with them in a group session. Forming real relationships with real people is a crucial part of treatment, which cannot be done as effectively in a virtual group. 

We keep our groups small and in person because we know how crucial these relationships are to treatment. We seek to foster a real group community, which eats, laughs, and cries together. In some cases, friendships are created that will endure beyond treatment.

Clinically Reviewed By

nick kahm reviewer

Nick Kahm, PhD


Nick Kahm, a former philosophy faculty member at St. Michael's College in Colchester, VT, transitioned from academia to running the Kahm Clinic with his mother. He started the clinic to train dietitians in using Metabolic Testing and Body Composition Analysis for helping people with eating disorders. Now, he is enthusiastic about expanding eating disorder treatment through the Kahm Center for Eating Disorders in Vermont.

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