San Francisco – Scientists from the University of California published on EurekAlert a study that involving parents in the treatment of adolescents with bulimia nervosa is more effective than treating the patient individually.
Bulimia is characterized by recurrent episodes of uncontrolled overeating, called binge episodes. These binge episodes are followed by compensatory behaviors aimed at preventing weight gain, such as self-induced vomiting, laxative or diuretic abuse, fasting, or intense exercising. This finding is counter to how clinicians are historically trained to care for adolescents with bulimia, which excludes the parents from treatment and counseling.
“Parents need to be actively involved in the treatment of kids and teens with eating disorders […] 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.” said Daniel Le Grange, PhD, Benioff UCSF Professor.
Between one and three percent of teens suffer from the condition each year in the United States, and most develop the disorder during their adolescence. Because the nature of bulimia is so secretive and the majority of bulimic adolescents remain at a healthy weight, many teens live with the disorder for years before their parents recognize the signs.
The study compared two treatments on 130 adolescents age 12 to 18 with bulimia nervosa, 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.
Participants in family based therapy achieved higher abstinence rates from binging and purging than the patients in individual cognitive based therapy.
“These findings are quite clear […] 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.