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Involving parents in therapy doubles success rates for bulimia treatment
September 04, 2007In the first randomized controlled trial for adolescent bulimia nervosa to be completed in the US, researchers show that mobilizing parents to help an adolescent overcome the disorder can double the percentage of teens who were able to abstain from binge eating and purging after six months.
In the September issue of Archives of General Psychiatry, a team based at the University of Chicago Medical Center show that almost 40 percent of participants in family-based treatment had stopped binging and purging compared to only18 percent of those who received supportive psychotherapy, the standard therapy. Six-months after treatment, almost 30 percent of participants who received family-based treatment were still abstinent compared to only 10 percent of participants who received supportive psychotherapy, which focuses on issues underlying the eating disorder.
"Parents are in a unique position to help their adolescents," says study author Dr Daniel le Grange, Associate Professor of Psychiatry and Director of the Eating Disorders Program at the University of Chicago, "yet treatment typically excludes them from the process. Now we have the evidence that we need to bring them back in."
The trial, conducted at the University of Chicago, involved 80 adolescents, aged 12 to 19, with a diagnosis of bulimia nervosa (typically characterized by binge eating and purging) or a strict definition of partial bulimia nervosa.
Forty-one patients were randomly assigned to family-based treatment, and thirty-nine patients were randomly assigned to supportive psychotherapy. Patients from each group made 20 visits to the clinic over a six-month period.
In family-based treatment, parents and at times even siblings attend clinic sessions with the patient. Parents play an active follow-up role at home, encouraging their adolescents to eat as normally as possible, then monitoring them during and after meals to make sure they eat and are not tempted to purge.
"For years parents have been left out of the treatment process," Le Grange said. They often feel guilty about intervening. "But what parent would step aside and play a minimal role in treatment if their child was diagnosed with cancer" Nor should they if a child has an eating disorder. Eating disorders pose serious health hazards."
Although the family-based approach produced superior results, the research team is uncertain whether it was the family involvement or the focus on eating behavior found in family-based treatment that was responsible for the improved outcomes.
"We still have work to do on understanding and treating eating disorders," Le Grange said. "While we're happy for how well this approach has done, obviously abstinence rates between 30 to 40 percent leave considerable room for improvement."
University of Chicago Medical Center
The trial, conducted at the University of Chicago, involved 80 adolescents, aged 12 to 19, with a diagnosis of bulimia nervosa (typically characterized by binge eating and purging) or a strict definition of partial bulimia nervosa.
Forty-one patients were randomly assigned to family-based treatment, and thirty-nine patients were randomly assigned to supportive psychotherapy. Patients from each group made 20 visits to the clinic over a six-month period.
In family-based treatment, parents and at times even siblings attend clinic sessions with the patient. Parents play an active follow-up role at home, encouraging their adolescents to eat as normally as possible, then monitoring them during and after meals to make sure they eat and are not tempted to purge.
"For years parents have been left out of the treatment process," Le Grange said. They often feel guilty about intervening. "But what parent would step aside and play a minimal role in treatment if their child was diagnosed with cancer" Nor should they if a child has an eating disorder. Eating disorders pose serious health hazards."
Although the family-based approach produced superior results, the research team is uncertain whether it was the family involvement or the focus on eating behavior found in family-based treatment that was responsible for the improved outcomes.
"We still have work to do on understanding and treating eating disorders," Le Grange said. "While we're happy for how well this approach has done, obviously abstinence rates between 30 to 40 percent leave considerable room for improvement."
University of Chicago Medical Center
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It Started With Pop-Tarts... An Alternative Approach to Winning the Battle of Bulimia by Lori Hanson (Author) It Started With Pop-Tarts is a Mom's Choice Award Silver Recipient for Body, Mind & Spirit! It Started with Pop-Tarts is a personal story of a 30+ year battle with an eating disorder. Written to bring hope and inspiration to individuals suffering with eating disorders and to enlighten loved ones to the depths of this obsession. Hanson's book outlines her practical holistic approach to recovery employing mind, body and spirit. Hanson delves into the chemical contributors to binge eating and discusses the importance of balancing body chemistry along with reprogramming the negative self-talk and behaviors and improving self-esteem. Author Lori Hanson's bulimia was at its worst during college and as a young career woman. After a bout with counseling in her twenties Hanson looked for... |
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Thin Starring: Brittany Robinson, Alisa Williams (II), Polly Williams (III), Shelly Guillory Directed By: Lauren Greenfield The HBO Documentary film Thin takes us inside the walls of Renfrew Center, a residential facility for the treatment of women with eating disorders, closely following four young women (ages 15 - 30) who have spent their lives starving themselves?often to the verge of death. The film deftly chronicles the pervasiveness of restrictive eating behaviors (most of the women profiled learned dysfunctional eating habits from their mothers while growing up), as well as the failure of our current health-insurance industry to address its clients' needs, while never shifting focus from the women themselves. Director Lauren Greenfield documents with astonishing depth the daily rituals, spontaneous friendships and startling swings between recovery and relapse that make up life at the center. The result... |
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Andrea's Voice: Silenced by Bulimia: Her Story and Her Mother's Journey Through Grief Toward Understanding by Doris Smeltzer (Author), Carolyn Costin (Foreword), Andrea Lynn Smeltzer (Foreword), Andrea Lynn Smeltzer (Foreword) Vibrant, talented, strong, and beautiful, Andrea Smeltzer seemed destined for a great future. But after a one-year struggle with bulimia, she died in her sleep at age 19, catapulting her mother Doris into a wrenching but ultimately rewarding journey of discovery. This unabashed account not only speaks about one family’s tragedy, but also critiques the social and personal attitudes toward our bodies and appearance that create victims like Andrea. Andrea's poetry and journal entries, combined with her mother's reflections, offer insight and understanding about a crushing disorder that afflicts far too many young people. |
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