Bulimic teens recover faster if parents are involved
In traditional treatment of bulimia in teens, parents are excluded from treatment and counseling. But a new study shows that parental involvement can speed up a teen’s recovery from the eating disorder. Bulimia is described by overeating and then methods like forced vomiting to avoid weight gain.
The study was led by Daniel Le Grange, PhD, Benioff UCSF Professor in children’s health in the departments of psychiatry and pediatrics at UCSF Benioff Children’s Hospital San Francisco, and James Lock, MD, PhD, professor of psychiatry at Stanford University School of Medicine. The study is the third and largest randomized clinical trial for adolescents with bulimia nervosa.
“Parents need to be actively involved in the treatment of kids and teens with eating disorders,” said Le Grange. “This study shows definitively that parental engagement is imperative for a successful outcome of adolescents with bulimia nervosa. It goes counter to the training that physicians receive in psychiatry, which teaches that parents are to blame for bulimia, and therefore should be omitted from treatment.”
The study compared two treatments, cognitive behavioral therapy (CBT) and family based therapy (FBT). CBT focuses on the individual patient, stressing skills training that helps patients gain a thorough understanding of themselves and the irrational thoughts that are causing them to binge and purge. By recognizing and confronting these irrational thoughts, they can change their behavior and healing can occur. FBT works with parents to understand the severity of the disorder and learn how to best support their children on a daily basis to keep them medically safe, and support healthy habits.
In the study, which took place at The University of Chicago (when UCSF’s Le Grange was on the faculty there), and Stanford University, the researchers randomized 130 adolescents age 12 to 18 with bulimia nervosa to either receive CBT or FBT. Treatments included 18 outpatient sessions over six months, with follow-up at six and 12 months.
Participants in family based therapy achieved higher abstinence rates from binging and purging than the patients in individual cognitive based therapy. At the end of initial treatment, 39% of FBT patients were abstaining from binging and purging versus 20% of CBT patients, and at the six-month follow-up 44% of FBT patients were not bingeing and purging versus 25% of CBT patients. At 12 months, FBT was clinically superior to CBT as well, with abstinence rates at 49% for FBT versus 32% for CBT.
“These findings are quite clear,” said Le Grange. “FBT is the treatment of choice for adolescents with bulimia nervosa, because it works quicker and faster and maintains its impact over time. CBT could be a useful alternative if FBT were not available, but it needs to be recognized that it doesn’t work quite as fast and takes time to catch up,” said Le Grange.
Category: Features, Wellness and Complementary Therapies
