Family based treatments are likely to work better and faster in treating anorexia nervosa in teenagers, rather than the traditional therapy that focus on individual rehabilitation of the patient, suggests a new study.Eating disorders such as anorexia nervosa and bulimia affect millions of teens and young women worldwide and are more common in people in fashion, media and showbiz, who are normally preoccupied with body image.
Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss, while bulimia is characterized by a secretive cycle of binge eating followed by purging through self-induced vomiting, inappropriate use of laxatives or enemas, or excessive exercise.
Anorexics recover better with parental help
Until now most anorexic teens have been getting intensive one-on-one therapy, but a new study from the University of Chicago finds that involving the entire family may be more effective in treating the condition, which is most common among teenage girls.
"Family therapy has been part of the landscape for the treatment of anorexia nervosa for maybe 40 years, but this specific form has been evolving as a likely effective treatment for the last 10," said study lead author Dr. James Lock, a professor of psychiatry and behavioral sciences at Stanford University, as reported by Business Week. "But this is the first study to actually compare this treatment to an active treatment."
Patients in the family-based therapy were also less likely to relapse from full remission, with only 10 percent falling back into their anorexia, compared with 40 percent of patients who received the individual treatment.
Individual vs family-based therapy
According to the researchers, the study family-based treatment appeared superior to individual therapy for leading to long-term recovery.
Individual or teen-centered therapy focuses on helping a starving child learn to manage his or her eating and weight gain, and to keep the patient from family. This therapy has been around longer and is more widely practiced than family-based therapy, Lock said.
Family-based therapy puts family initially in charge of changing their child's behavior, with parents coaching the malnourished child at meal times and making sure the anorexic sufferer doesn't overexercise.
"The idea here is that the disorder is disabling and confusing to both the patient and to the family, and that the family actually needs to learn how to help directly solve the problem of the child eating and over-exercising, and find solutions at home where the child is living," explained Lock.
Study details
For the study, Lock and colleagues randomly assigned 120 patients with anorexia, ages 12 to 18, to one of the two treatments for one year.
All the study subjects were evaluated before treatment, and six months and one year after treatment.
Findings
Six months later, 40 percent of patients who received family-based therapy had achieved full remission, and one year later 49 percent had recovered, compared with 18 percent and 23 percent of patients in the individual therapy, respectively.
Patients in the family-based therapy were also less likely to relapse from full remission, with only 10 percent falling back into their anorexia, compared with 40 percent of patients who received the individual treatment.
Also, the patients in family-based treatment did better in how they thought about and dealt with food.
Family treatment better
"For a really long time, parents have been seen as being an obstacle to treatment," said Lock. "Family-based treatment and the effectiveness that it has shown in this study suggests that families really are a resource to these kids, and they really should be included in the care of their children."
"It's behaviorally focused. It's process focused. It absolutely really makes the point that families, as far as we know, aren't the cause," Lock said. The authors reported their findings in the October issue of 'Archives of General Psychiatry.'