Parental direction works, but don’t expect your kid to be happy about it: Research on The Family Meal in FBT

family at family meal in FBT [Image description: a family with their backs to us sits around a table] Represents a potential family in California receiving FBT for their teens eating disorder

Family-Based Treatment (FBT) is the best-researched outpatient treatment for teen eating disorders, including anorexia. In FBT, the family plays a central role in treatment. Through family meals, parents restore their teens to health and interrupt eating disorder behaviors. In FBT, parents plan, prepare, serve, and supervise meals. Usually, parents are left wondering 1) how to …

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Recognizing and Managing the Subtler Signs of Starvation in Children with EDs

Signs of Anorexia

This interaction on twitter caught my eye: Watching cooking shows, collecting and reading recipes, and cooking for others (but not eating it oneself) are some of the earliest signs of anorexia that are often missed and misinterpreted by parents.  In Keys’ landmark study “The Biology of Human Starvation” male volunteers were put on starvation diets.  …

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Empirically Validated Treatments

Empirically Validated Treatments For Eating Disorders Today’s Los Angeles Times contained an article which highlights Family Based Treatment and Cognitive Behavioral Treatment, two treatments I provide: Today, doctors and therapists focus on a handful of treatments that have been validated by clinical studies. For teens with anorexia, the first-line treatment is something called family-based therapy, …

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Traveling With a Teen With Anorexia

Traveling With Your Anorexic

By Lauren Muhlheim, Psy.D. and Therese Waterhous, Ph.D. Traveling with a Teen With Anorexia can feel like you are literally “traveling with anorexia” –like a monster has joined your trip. Learn more about the risks and consider carefully before proceeding. Traveling With A Teen With Anorexia in Phase 1 Families often ask whether they should …

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Exposure in the treatment of Eating Disorders

Exposure therapy is widely recognized as a necessary (and sometimes sufficient) ingredient of treatment for most of the anxiety disorders including phobias, panic disorder, and obsessive compulsive disorder.  Anxiety is a core psychological feature of anorexia nervosa and bulimia nervosa.  However, instead of being afraid of heights, speaking in public, having a heart attack, or contamination, individuals with eating disorders are primarily afraid of food, eating, and shape and weight.

Both cognitive-behavioral therapy and family based treatment, two empirically validated treatments for eating disorders, employ exposure techniques.  Exposure works through the process of habituation, the natural neurologically-based tendency to get used to things to which you are exposed for a long time.   During exposure, habituation occurs as people acclimate to their fear and come to realize that nothing actually dangerous is occurring. Habituation promotes new learning of safety, tolerance of fear feelings, and extinction of the fear avoidance urge. 

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Starting FBT: Surviving The First Week of Re-Feeding

Surviving The First Week of Re-feeding Your Teen Using Family-Based Treatment In Family-Based Treatment (FBT), figuring out how to get your starving child to eat and gain weight is a daunting task. Parents often feel overwhelmed and helpless when starting out on a re-feeding program. It is important to remember that your child is literally …

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Mindful Eating

The definition of binge eating is “the consumption of large amounts of food associated with a feeling of loss of control over eating.”  Individuals who binge eat describe the experience as almost dissociative.  They are frantically eating large amounts of food which they are barely tasting.  They feel unable to stop until they are uncomfortably full.

One skill that I teach clients who binge eat and overeat is mindful eating.  Mindfulness is a Buddhist principle that involves being fully aware of what is going on both inside yourself and in your environment at the moment.  Mindfulness is a skill that anyone can develop.

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Family-based treatment for adolescent eating disorders

Eating disorders, including Anorexia Nervosa and Bulimia Nervosa, are affecting greater numbers of adolescents and even children and early intervention is critical. If not identified or treated early, eating disorders can become chronic and cause serious or even life-threatening medical problems. Anorexia Nervosa is the most dangerous, with the highest death rate, of any mental …

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