Living With Food: The Science Supporting Eating Disorder Treatment

By Dr. Jorey Friedman Beegun and Dr. Mark Warren

One of the most exciting developments in eating disorder treatment has been the Maudsley method of family based therapy (FBT). For adolescents with eating disorders, both the research and our clinical experience point to the effectiveness of the Maudsley method in the stabilization of difficult to treat illnesses for which there may be a poor prognosis based on the complexities of the illnesses and historically ineffective treatment. While there is push for funding to continue studying these disorders in children and adolescents, the research published in the last few years clearly points to overwhelming benefit of involving parents in eating disorder treatment. For adolescents who have had their illness less than three years, are under 19 years old, and living at home, it remains the only evidence-based treatment for anorexia. In a study comparing a family-oriented approach to individual supportive therapy for those with bulimia or frequent binge/purge symptoms that might not meet the diagnostic criteria for bulimia, parent involvement more than doubled the number of adolescents who were able to abstain from their symptoms at the 6 month follow-up. At CCED, we have had considerable success with the application of this model for patients who don't fall specifically within these guidelines and are working on ways to study this in a more formalized manner. 

The core of FBT is the understanding that parents don't cause eating disorders, but instead play the primary role in the successful treatment of their child's eating disorder. For too long, parents of children with eating disorders were viewed as one of the causes of their child's illness. We are now aware that this belief is false, has no scientific support, and has likely resulted in significant damage for those who suffer from eating disorders by removing the people from their treatment plan who know and love them the most - their family. In the FBT treatment model, parents are seen as the primary treatment providers who receive coaching and support from a knowledgeable therapy treatment team. Both research and our years of clinical practice of FBT has demonstrated that parents can have extraordinary success in restoring their child's health.

There are multiple excellent resources online for FBT. Two in particular we recommend are F.E.A.S.T. and Maudsley Parents. If you have a child or loved one with an eating disorder we strongly encourage you to become familiar with this treatment model. In addition, we recommend an excellent book, Help Your Teenager Beat an Eating Disorder, written by Dr. James Lock and Dr. Daniel LeGrange, two experts in the eating disorder field. They are responsible for the most recent published research using the Maudsley method for parents considering and/or currently doing this form of therapy.

Next week: What are the phases of the Maudsley method? 

Contributions by Sarah Emerman