Family Systems Therapy Versus the Maudsley Approach for Treating Anorexia in Adolescents

A new study will compare the effectiveness of Family Systems Therapy versus Behavioral Family Therapy (also known as the Maudsley Approach) for treating anorexia nervosa in adolescents aged 12-18 years old.

Individuals with anorexia nervosa have an intense fear of gaining weight, even though they are underweight, refuse to maintain weight that is 85% of their expected weight given their height and age, have a distorted body image, and miss three consecutive menstrual cycles in a row (for females). Anorexia is a life-threatening illness and has a high morbidity rate.

Both of the therapies that will be examined in the study involve the use of the family in treatment. In the Maudsley Approach, the individual suffering with anorexia attends therapy sessions with his or her parents and siblings. Parents work with the therapist in order to figure out what types of foods and how much of these foods must be consumed in order for the affected individual to gain a healthy amount of weight back. Parents must supervise every meal and work at ensuring that each meal is completed. Siblings are encouraged to act as a support system to the affected individual. Once the affected individual has regained a healthy amount of weight, he or she is gradually granted increasing responsibility for choosing his or her own meals again. Additionally, once a healthy weight has been reached, family and developmental issues are addressed in therapy.

In Family Systems Therapy, family members can address any family stressors or problematic communication patterns during therapy sessions.

Two-hundred and forty adolescents aged 12-18 years old are being recruited to participate in this study. All participants must be between 75-87% of their healthy body weight, and medically stable. All families will be randomly assigned to participate in the Maudsley Approach or Family Systems Therapy for nine months. Each family will attend weekly therapy sessions for the first 7-8 weeks of the study, followed by six bi-weekly sessions, and finally monthly therapy sessions for the remainder of the study.

The study will be taking place at six different locations: New York Presbyterian/Westchester, Sheppard Pratt in Baltimore, University of Toronto, Stanford University in Palo Alto, Washington University in St. Louis, and University of California in San Diego.

If you are interested in participating in this study, you can e-mail the study's coordinator, Samantha Berthod at: sab2024@med.cornell.edu.

Eating disorders as coping mechanisms

Eating disorders are coping mechanisms.

When one focuses on food, weight, and his or her body image, he or she is avoiding the emotions that underlie the disorder.

A girl's parents get a divorce and she uses self-starvation to deal with her feelings of guilt, hurt, and sadness.

A boy is bullied at school and he uses binge eating in order to stuff his feelings of inadequacy, rejection, and shame.

Oftentimes, individuals who suffer from eating disorders aren't even aware of why they are using them as coping mechanisms. The goal of therapy is to uncover the underlying issues, to raise self-esteem, and to learn how to cope with feelings healthily.

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