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Eating Disorder Professional Treatment - Family Therapy

Bridget Engel, Psy.D., edited by Kathryn Patricelli, MA

An eating disorder impacts family members and can also disrupt their daily routines, holidays, and vacations. Family members experience pain and strong emotions while watching the person suffer, and often feel powerless. Families with an eating disordered individual are often struggling with other addictions, emotional problems, disturbed behaviors, and interpersonal conflicts.

Family therapy is a type of therapy where the entire immediate family participates. This is highly recommended in combination with individual treatment. Family therapy can be used to provide loved ones with education, support, communication skills, and conflict resolution. The family therapist can also teach members how to respond without trying to control or protect the person. Another important aspect of family therapy is teaching members how to have realistic expectations of one another, and reorganizing faulty roles and poor boundaries. The family therapist teaches how expectations are communicated to others and what might be reasonable and achievable. Family members must be given permission and assistance in developing their own separate and healthy identities. A strong, united, and supportive parenting team must be established when the patient is a teen.

Multifamily groups are an excellent way for families to get extra support during the treatment process. These groups offer an opportunity for several families to come together to have supportive discussions about what it's like to have someone they love with an eating disorder. It also creates understanding as members talk with individuals from other families who have eating disorders. A therapist trained in the treatment of eating disorders coordinates the discussions.

Other supportive treatments can also be helpful. For example, guided imagery, relaxation training, and hypnosis are sometimes used to decrease binge episodes in those with bulimia or binge-eating disorder. These options work by decreasing anxiety, coping with negative emotions, and reducing impulsiveness. These strategies are practiced as a substitution for binge eating behaviors.

In addition, psychiatric medications are given in some cases to control the symptoms of eating disorders and co-existing conditions. However, medications cannot cure or eliminate any eating disorders. Certain forms of antidepressants have been shown to decrease binging in those with bulimia and to help to restore weight and prevent relapse in those recovering from anorexia. Appetite stimulants can help to boost treatment for some with anorexia and bulimia. Anti-anxiety and antipsychotic medications (which help to stabilize mood and clear thinking) have been shown to be especially effective for those with anorexia who have high levels of anxiety and obsessive thinking.

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