For Teens With Bulimia, Family Based Treatment is Recommended

Teens With Bulimia Family Based Treatment

My original eating disorder training began in 1991 with learning Cognitive Behavioral Therapy (CBT) for bulimia nervosa (BN) under G. Terence Wilson, the co-author with Dr. Christopher G. Fairburn, of the treatment approach that preceded CBT-E. In 2010 I underwent training in Family Based Treatment (FBT) for Adolescent Anorexia Nervosa (AN) and became certified in …

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Is Your Young Adult with an Eating Disorder Ready for College?

Is My Young Adult With an Eating Disorder Ready for College?

College Readiness When Your Child Has an Eating Disorder How do you know whether your child with an eating disorder is ready for college? Sending a child to college usually raises anxiety for most parents. And you may have even more anxiety if your young adult has or has struggled with an eating disorder. Starting …

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Presentation at NEDA 2015 conference

Lauren and Katie presenting NEDA 2015

Katie and I had the honor of presenting in the Individual, Family, and Friends track at the National Eating Disorder Association Conference in San Diego yesterday.  The title of our talk was:  Family Based Nutrition Therapy:  Creating A Supportive Environment.  It was a chance to share the way we work to support families who are …

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FBT Insights from the Neonatal Kitten Nursery

FBT Insights from the Kitten Nursery

I recently began volunteering at the Best Friends Neonatal Kitten Nursery. Best Friends Los Angeles opened its neonatal kitten nursery in February 2013.  The nursery is staffed with a dedicated coordinator and supported by volunteers who sign up for two hour feeding shifts 24 hours a day to help the kittens grow and thrive. If …

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Parental direction works, but don’t expect your kid to be happy about it: Research on The Family Meal in FBT

Parents charged with helping their children to recover in Family-Based Treatment often wonder 1) how to actually get their children to eat and 2) whether they will harm their children or the parent-child relationship by requiring them to eat. A recent study addressed these concerns by looking at the family meal.         …

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Recognizing and Managing the Subtler Signs of Starvation in Children with EDs

Signs of Anorexia

This interaction on twitter caught my eye: Watching cooking shows, collecting and reading recipes, and cooking for others (but not eating it oneself) are some of the earliest signs of anorexia that are often missed and misinterpreted by parents.  In Keys’ landmark study “The Biology of Human Starvation” male volunteers were put on starvation diets.  …

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Highlights from #ICED2014: The FBT Debate

Drs. Le Grange and Strober

ICED 2014 in New York provided a wonderful opportunity to connect with colleagues from around the world who share a commitment to providing treatment to those suffering from eating disorders. Among the highlights for me were the well-attended, first-ever tweetUP and my official appointment as Board Director for Outreach of the Academy for Eating Disorders. …

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FBT Meal Strategies Gleaned from Ziplining

FBT Meal Strategies Gleaned from Ziplining

Understanding and Responding to Your Youngster’s Fear: A Metaphor I often explain to parents that for a youngster suffering from an eating disorder, a meal can feel dangerous – like jumping out of an airplane. A couple of years ago I had the opportunity to (almost) live out this metaphor on a family vacation. This …

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Traveling With a Teen With Anorexia

Traveling With Your Anorexic

By Lauren Muhlheim, Psy.D. and Therese Waterhous, Ph.D. Traveling with a Teen With Anorexia can feel like you are literally “traveling with anorexia” –like a monster has joined your trip. Learn more about the risks and consider carefully before proceeding. Traveling With A Teen With Anorexia in Phase 1 Families often ask whether they should …

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Exposure in the treatment of Eating Disorders

Exposure therapy is widely recognized as a necessary (and sometimes sufficient) ingredient of treatment for most of the anxiety disorders including phobias, panic disorder, and obsessive compulsive disorder.  Anxiety is a core psychological feature of anorexia nervosa and bulimia nervosa.  However, instead of being afraid of heights, speaking in public, having a heart attack, or contamination, individuals with eating disorders are primarily afraid of food, eating, and shape and weight.

Both cognitive-behavioral therapy and family based treatment, two empirically validated treatments for eating disorders, employ exposure techniques.  Exposure works through the process of habituation, the natural neurologically-based tendency to get used to things to which you are exposed for a long time.   During exposure, habituation occurs as people acclimate to their fear and come to realize that nothing actually dangerous is occurring. Habituation promotes new learning of safety, tolerance of fear feelings, and extinction of the fear avoidance urge. 

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