By Kathleen Doheny
When a teenager has an eating disorder, it's not just the teen's problem. It's a family problem.
So, parents should join in on the treatment, a growing number of experts believe.
With parental involvement, "the outcome is likely to be improved," said Dr. Ovidio Bermudez, medical director of the eating disorders program at Laureate Psychiatric Clinic and Hospital in Tulsa, Okla., and a member of the board of directors of the National Eating Disorders Association.
Nearly 10 million females and 1 million males in the United States have an eating disorder, according to the National Eating Disorders Association. Federal government statistics show that more than 90 percent of them are females aged 12 to 25.
People with bulimia binge eat and then purge, whereas those with anorexia nervosa limit food and become dangerously thin because they believe they're too heavy when, in fact, they're not.
But the thinking about the causes of eating disorders and their treatment has come full circle, Bermudez said. Many years ago, experts blamed eating disorders on controlling mothers and distant fathers, among other theories. But today they generally concur that the disorders are not due to those factors.
"We know now that eating disorders are real illnesses, not lifestyle choices," Bermudez said. And parents can play a crucial role in recovery, Bermudez and others now believe.
In fact, researchers found that teens were more able to control their disordered eating when they had family support.
One study involving 80 teens with bulimia put about half in a treatment program that included family therapy and the others in more traditional psychotherapy. Six months later, the success rate for those given family therapy was twice as great as it was for the others.
About 40 percent of teens whose families participated in their treatment had stopped bingeing and purging, compared with 18 percent of those treated without family involvement. The study was published in theArchives of General Psychiatry.
Another study, published in the journal Eating Disorders, followed 32 teenage girls with anorexia and found that 75 percent of them were in full remission three years after treatment that had included family therapy.
Just what does the treatment, generally known as behavioral family therapy, involve?
"The therapist works with the family to empower the family to get the [anorectic] child to eat the meals and recover the weight," Bermudez said. "The family becomes the agent of change."
He said that the approach has been studied more in anorexia than in bulimia but that it is used for both.
In bulimia, the parents' role at home would be to get their teen to eat regular meals so the teen doesn't binge then purge, Bermudez said.
It doesn't always work, he said, but it is generally viewed as promising and effective.
The approach did work for the daughter of Deborah, a 50-something mother in Orlando, Fla. She and her husband were stunned when their daughter, Allison, now 25, told them she needed help. "She had lost a lot of weight," Deborah recalled.
They sought help and participated in a family-centered treatment approach. "I was in the counseling session with Allison and the therapist," Deborah recalled. It helped her understand the disorder, she said, and how better to help.
But Deborah did much more than sit in the counseling sessions. "We built a team around Allison," she said. Besides the therapist, the team included the family doctor, a nutritionist, Allison and her parents.
Parents can take other steps to help a teen recover from an eating disorder. Suggestions include:
- Educate yourself. "I would sit up at night and read," Deborah said, "so I could understand Allison and what she was experiencing."
- Be there emotionally. For her daughter, Deborah recalled, knowing that she could count on her parents' aid and support helped a great deal.
- Don't be in denial. If you suspected your child had cancer, Bermudez asked, wouldn't you get help immediately? It's just as crucial for a suspected eating disorder.
- Follow directions."Listen to your treatment team," Bermudez tells parents. The best treatment plans are individualized.
Allison's family-centered treatment, begun at the start of her senior year in high school, was successful. In college, she began to speak on the topic and now heads up the junior board of directors for the National Eating Disorders Association.
The National Eating Disorders Association has more for parents of teens with eating disorders.