Family Based Treatment for Eating Disorders Therapy and Counseling Program

Eating Disorders are a grouping of mental health conditions that are known for affecting eating behaviors, weight, and body image. Eating disorders can have a significant impact on a persons physical health and mental wellness when left untreated. Eating disorders can affect individuals of diverse ages, genders, and other characteristics.

There are several types of eating disorders that, with the most common being:

• Anorexia nervosa: There are two subtypes of anorexia that have varying symptoms. Restrictive type is when an individual loses weight by fasting, excessive exercise, and extreme dieting. Bing-eating/purging type is when someone engages in typical anorexic food restriction behaviors, with times of binge-eating and purging behaviors.
• Bulimia nervosa: Bulimia nervosa generally involves a pattern of alternating extreme dieting and low caloric intake, with binge-eating high calorie or “forbidden foods”. Binge-eating is described as eating a large amount of food in one sitting, often done in secret. Individuals often feel out of control during binges, and eat until they are past the point of feeling full, which can include abdominal discomfort and nausea.
• Bing eating disorder: The key difference between binge-eating disorder and bulimia nervosa is that those who are struggling with binge-eating disorder do not engage in compensatory behaviors like purging or extreme dieting. The behaviors associated with a binge are identical.
• Avoidant Restrictive Food Intake Disorder (ARFID): ARFID is marked by eating disturbances that do not meet nutritional needs because of picky eating. This could be the result of a lack of appetite, low interest in food, food avoidance for sensory characteristics, and experiencing anxiety regarding eating. Some experience persistent worry or fear of chocking, becoming nauseous, feeling constipated, or having an allergic reaction to food.
• Other Specified Feeding and Eating Disorder (OSFED): OSFED is a broad category that can be used when there are clinical disturbances in eating behaviors that impair functioning at work, school, in social settings, or within a family. These symptoms do not meet the full criteria for other eating disorders, but still have a significant impact on overall well-being.

There are a number of signs that you may notice when someone is struggling with an eating disorder. As we mentioned earlier, there is a range of eating disorders, each of which has their own symptoms and treatments. In most cases, eating disorders have a combination of physical and emotional signs.

Some of the signs and symptoms of an eating disorder that you may recognize include:

• Preoccupation with weight and food: This can include calorie counting, restrictive eating, and a focus on eating only “healthy foods.” There is often a strong preoccupation or fear about gaining weight.
• Behavioral changes reading eating habits: This can include skipping meals, binge-eating, or avoiding social meals. Eating in secret and hiding food can also occur.
• Emotional changes: May include anxiety, depression, and irritability. This can also include withdrawal from family and friends

• Physical symptoms: Can include dizziness, fatigue, fainting, dry skin, brittle nails, hair thinning, or digestive issues.

• Weight fluctuations: There can be rapid weight loss or gain, depending on the eating disorder. You may also notice that they are maintaining a weight above or below a healthy range.

• Distorted body image: This can include a persistent belief that they are overweight, even thought they are underweight. They may compare their body to others, and be preoccupied with particular areas of the body that appear normal to others.

Family-based treatment for eating disorders often takes place in outpatient treatment centers for long-term treatment. It is not uncommon for there to be challenges in implementing FBT practices initially, but families are encouraged to be consistent in their efforts. The time frame associated with FBT therapy typically falls between six months to one year.

In the beginning, FBT eating disorder treatment can include weekly therapy sessions. Over time, the frequency and intensity decreased to reflect the progress that is made in treatment. It is important that families allocate time in their routine for supervised meals, and for other therapy activities. There is a strong importance of family dynamics in recovery, and working to have a healthy and supportive environment. Time may be spent improving communication skills in family-based treatment sessions.

Family-based treatment is broken down into three phases. This approach allows behavioral health centers to provide support that is supportive and collaborative. Treatment has an emphasis on teamwork, accountability, and communication. Continue reading for more on FBT phase 1,2, and 3 explained:

• Phase 1, Weight Restoration: This phase focuses on reaching a healthy weight and addressing malnutrition that resulted from disordered eating. In this stage, parents are controlling meal planning to ensure that it includes proper nutrition. There is a structure for regular eating, to help create a supportive environment. Parents learn to recognize and manage harmful eating behaviors.
• Phase 2, Returning Control to the Adolescent: In this phase, parents gradually give control of eating back to the adolescent. This allows them to begin making healthy and independent choices regarding their eating behaviors. The role of parents in eating disorder treatment is active in monitoring meals, building trust, and using healthy communication patterns.
• Phase 3, Establishing Normal Adolescent Behaviors: Adolescent will now be able to address the underlying developmental, emotional, and social challenges that were contributing to their disordered eating behaviors. There is a shift towards having a typical routine, including socializing and creating personal goals. This stage will include relapse prevention and long-term recovery strategies.