The Family's Role in Recovery from Eating Disorders

Douglas Bunnell, PhD, clinical director of the Monte Nido treatment center for eating disorders, talks about how the latest clinical evidence points to the importance of family members in recovery. A tip: if parents are getting “push-back” about their involvement in treatment, “that’s a warning sign.”

Family involvement in the treatment of eating disorders is really now seen as central and essential, and clearly for kids, young kids, adolescents, and sort of pushing the barrier out a bit even for older adolescents and young adults, especially those still living at home, the family needs to be involved in treatment.

And one of the ways families can tell whether they’re getting competent, cutting-edge treatment for eating disorders is really checking in with the clinician’s attitude about family involvement. If you’re getting pushback about being involved in your kid’s treatment, that’s a warning sign. You should be welcomed in, you should be having your questions answered straightforwardly about what the family’s role should be.

The best evidence-based treatment we have for anorexia nervosa of any age is family-based treatment or Maudsley treatment. It’s got the strongest evidence base. It’s really been evidence-generated for treatment of young kids and teens with anorexia, but there are trials underway for older kids as well, and the core of that treatment is putting the family in charge of refeeding. The clinicians working largely with the mom and dad or the family to really create an environment where they are establishing consistency with a calm, compassionate tone to really make or help their daughter understand that she needs to take this medicine, food, to recover from this life-threatening illness. That’s sort of the gist of it. It’s much more complicated than that, and it sort of sounds simple on paper, but it’s not simple. It can be really gut-wrenching, difficult work, but there’s pretty strong evidence that for a big percentage of kids, particularly early on with anorexia nervosa, it can be very effective.