We often think of eating disorders as only affecting the person suffering, but the impacts of an eating disorder can be much more widespread. No one ever wants to see a loved one struggle. Eating disorders can affect a person’s partners, friends, and family members. However, the opposite can also be true. Sometimes, without knowing, friends and family members can contribute to the development of their loved one’s eating disorder. We often see this dynamic between a teenager and their parents. As a result, one of the most effective methods of treatment for eating disorders is Family-Based Treatment (FBT). Read on to learn more about Family-Based Treatment for eating disorders and the various phases of treatment.
What is Family-Based Treatment?
Family-Based Therapy (FBT) is an eating disorder treatment method that is evidence-based. It has been mainly studied in adolescents. It is considered the gold standard of treatment for eating disorders in this age group. If an adolescent is medically stable, FBT can be implemented at home as an alternative to a higher level of care.
There are several principles of FBT that help set the stage for this model of treatment. First, parents are not the causes of eating disorders. The cause of eating disorders is unknown and is often thought to be multifactorial. However, it may be important to acknowledge past messaging from parents that may have aligned with the eating disorder. Second, adolescents are not to be blamed for their eating disorders. People do not choose to have eating disorders. Eating disorders are a serious and complex mental illness. Therefore, it is important to separate the individual from their eating disorder.
What Types of Eating Disorders Does Family-Based Treatment Help With?
As mentioned before, FBT is most effective for children and teenagers. Oftentimes, younger patients with eating disorders lack the motivation to try to get better. FBT recognizes this and can work around this lack of motivation. Below is a list of eating disorders that FBT works well with. These types of eating disorders are common in adolescents, which is why FBT is so effective at treating them.
Binge Eating Disorder (BED)
Avoidant Restrictive Food Intake Disorder (ARFID)
To learn more about ARDID check out our other blog, “6 Signs of ARFID.”
Other Specified Feeding or Eating Disorder (OSFED)
The 3 Phases of Family-Based Treatment
In the first phase of FBT, parents take over all aspects of food for the adolescent. This includes menu planning, cooking, portioning, and monitoring of meals and snacks. Registered dietitians who specialize in treating eating disorders are crucial in helping parents and adolescents navigate this phase. It is common for adolescents to resist FBT because they are essentially asked to give up their eating disorder behaviors. At the same time, they are often still experiencing eating disorder thoughts and urges. This can lead to a range of heightened emotions and even outbursts of which parents are often on the receiving end. It can be incredibly difficult for parents to see their adolescent in distress. Registered dietitians provide the meal plan, roadmap, language, and support to help empower parents. If an adolescent needs to restore weight, it is expected to occur during this phase.
In the second phase of FBT, parents allow adolescents to be more involved with the food. Parents can consider taking this step when their adolescent has weight restored and demonstrated improvements in eating disorder thoughts and behaviors. This phase happens slowly over time. It can include steps such as allowing the adolescent to choose or portion their own food. Registered dietitians can help parents determine what is appropriate and when, depending on their adolescent’s age and stage of recovery. This support is crucial in helping to prevent any lapses or relapses.
In the third phase of FBT, adolescents are allowed to be independent with food. Parents can consider taking this step if their adolescent can maintain a healthy weight (for their body) and normal eating behaviors. During this phase, adolescents are trusted to eat on their own again, including at school or at friend’s houses. They typically spend more time developing their sense of self outside of their eating disorder. Registered dietitians can work with adolescents directly to help them continue to develop a healthy relationship with food and their body. This often includes identifying and reframing unhelpful thoughts together.
Get Family-Based Treatment for Your Eating Disorder
Thank you for reading this resource on Family-Based Treatment for Eating Disorders. If you are considering FBT for your teen, we can help! At Courage to Nourish, our team of eating disorder dietitians is trained to help people from all backgrounds, including teens and adolescents, develop a more positive relationship with food. In addition to providing one-on-one counseling with clients, we have experience in FBT and offer family counseling to help guide those with loved ones suffering from an eating disorder. If you and your family are not sure what next steps to take in your teen’s recovery journey, we offer consults to help develop treatment plans. We also have numerous handouts and blog posts posted on our website that can serve as valuable resources for learning more about eating disorders and treatment options.
Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland. and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.
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As a professional who used to work in a corporate setting, I have seen the negative, daily impact that diet culture has on people’s lives. This led me to discover intuitive eating and Health At Every Size ©, which I now use in working with clients in recovery at the partial hospitalization and intensive outpatient level. I love helping clients find a way of nourishing, moving, and viewing their body that is satisfying and sustainable.