Family Involvement in Anorexia Treatment is More Beneficial
Treatment for eating disorders has traditionally focused on the individual rehabilitation of the patient, but researchers are learning that family involvement is a necessary component for ultimately being successful in beating conditions such as anorexia and bulimia. A study led by a team of researchers at Stanford University and the University of Chicago have found that involving the family in treatment is more than twice as effective as individual care.
Parents Part of the Solution in Eating Disorders
The researchers followed 121 adolescents between the ages of 12 and 18 who were diagnosed with anorexia. Half of the participants were treated with the standard individual therapy which focuses on identifying the psychological issues behind the eating disorder while the remaining half received a family-based treatment known as the Maudsley Method. Both groups received treatment for one year.
During the study, fewer teens enrolled in the family-based treatment were hospitalized for medical stabilization than those in the individual treatment group (15% vs 37%). Weight gain was faster among those in family therapy as well.
At follow-up, 49.3% of the patients enrolled in the family therapy group were in full remission, defined as reaching at least 95% of their normal body weight and scoring in the normal range on a psychiatric measure of disordered eating. In the individual therapy group, only 23% reached this successful outcome. Relapse rates were also lower for the Maudsley treatment group, at 10% versus 40% for the standard therapy.
The Maudsley Method was developed at the Maudsley Hospital in London 20 years ago. It opposes the notion that parents or families should be blamed for the development of an eating disorder. During the treatment, parents are taught to monitor their child’s eating and exercise behaviors and to support and reinforce healthy eating. Trials are currently ongoing to study the family-based treatment in adolescents diagnosed with bulimia.
Anorexia, defined by starvation-level dieting and/or excessive or obsessive exercise due to a distorted body image, affects about 1% of women and girls in the United States. It is fatal in about 10% of severe cases, usually due to suicide or heart failure.
"What this study unequivocally demonstrates is if you have an adolescent with anorexia nervosa who is medically stable, family based treatment should be the first line of treatment," said Daniel Le Grange, PhD, Professor of Psychiatry and Behavioral Neuroscience and Director of the Eating Disorders Clinic at the University of Chicago Medical Center. Le Grange and James Lock MD, PhD, Professor of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, are co-senior authors of the study, published in the October 4 issue of the Archives of General Psychiatry.
"Randomized Clinical Trial Comparing Family-Based Treatment With Adolescent-Focused Individual Therapy for Adolescents With Anorexia Nervosa"
James Lock, MD, PhD; Daniel Le Grange, PhD; W. Stewart Agras, MD; Ann Moye, PhD; Susan W. Bryson, MA, MS; Booil Jo, PhD
Arch Gen Psychiatry. 2010;67(10):1025-1032. doi:10.1001/archgenpsychiatry.2010.128