TL;DR
Family-Based Treatment (FBT) is not just for teens; it can be effective for adults, too. Originally designed for adolescents with anorexia and bulimia, FBT involves parental support in meal planning and supervision, which is crucial for recovery. Recent evidence suggests its application extends to young adults and older individuals, with many successfully using it in college settings or with family support via technology.
The approach emphasizes the importance of meal support, helping individuals confront their eating disorders in a compassionate environment. It’s recognized that needing assistance with meals is not a weakness, but rather a brave step towards recovery, regardless of age. Therefore, if you or someone you know struggles with eating disorders, consider exploring FBT as a valuable resource for support. Remember, reaching out for help can make a significant difference in the recovery journey!
FBT for Adults With Eating Disorders
Family-Based Treatment (FBT) is the leading evidence-based treatment for teens with anorexia nervosa and bulimia nervosa. One of the common misbeliefs I hear is that it’s “only for kids or younger teens.” However, I think it has much wider applicability. In fact, I would say that my FBT training has significantly improved my effectiveness in treating eating disorder patients of all ages.
How Does FBT in Los Angeles Work?
While there have not been studies of FBT that pull it apart and pinpoint the elements that drive its success, I have a few theories. One of the key underpinnings of FBT is meal support. People with eating disorders experience such crippling anxiety before, during, and after meals that it is no wonder they would do anything they can to avoid eating. When the brain is in a state of overwhelming anxiety, a person with an eating disorder cannot make logical decisions about what to eat—or even to eat. And yet, without eating, there can be no recovery. Treatment centers understand this—providing regular meals has been the mainstay of residential and partial hospitalization (PHP) eating disorder treatment for some time. FBT is the in-home parallel to this treatment.
In FBT, parents are charged with nourishing their teens back to health by providing regular nutrient-dense meals and preventing purging, excessive exercise, and other eating disorder behaviors. Parents plan, prepare, serve, and supervise meals and after meals if purging is an issue. They make all the food decisions. They sit with their struggling child during those terrifying meals and help their teens cope with eating amounts sufficient for them to get well. Over time, they return control to their teens, building their capacity to fight the eating disorder on their own.
It takes effort and time to change brain pathways that have made eating a scary experience. For this reason, even those patients with eating disorders who go on to higher levels of care usually don’t remain there long enough to develop the autonomous ability to eat enough to sustain recovery. They often continue to need meal support for some time after more intensive treatment.
Why Is FBT for Adults Successful?
I think FBT has applicability that spreads wider than just children and teens. There is preliminary evidence of its successful use with transition-age youth up to age 25. Many parents have reported successfully using it with their college-age children with eating disorders. I have used it with this age, and the primary variation is that the young adult plays a bigger role in their own treatment. They must agree at least in theory to accept their parents’—or other caregivers’—support. The young adult may choose who will support them during meals. Some, for example, may have a college roommate provide support. Some parents do meal support via FaceTime when the young adult lives far away.
I should clarify that FBT is a manualized evidence-based treatment. To be done with fidelity, it must comprise certain components, including a therapist who guides the parents in organizing their strategies to fight the eating disorder. Parents refeeding their child without a therapist’s oversight often state they are “doing FBT”. In this case, it is more accurate to say they are providing FBT-informed or carer-supported feeding. Regardless of the words we use to describe this support and whether or not a therapist is involved, I think it provides a core benefit that we can expand to other populations.
Our Experience With FBT for Adults
These principles can also be applied to adult treatment. As an FBT therapist in Los Angeles, I personally have supported an adult who was in PHP during the day and needed more support with meals outside of treatment hours. I applied the skills I learned in my FBT training to provide meal support to this person. It worked just like it did with teens. Obviously, this adult was an active participant in their recovery who asked for my support. This does not mean that I did not encounter the same kind of anxiety and resistance that parents meet around meals.
Take another case —a 20-something patient who still lives with her parents. She has been doing so much better since she asked for help, trading in the restrictive foods she had been eating on her own for several years for family meals prepared by her parents. Or the case of a college student who gets support via FaceTime from her parents, who live in another city. When working with young adults with eating disorders who are in loving relationships, we often work to help their significant others develop strategies to support them during meals.
My Experience is Not Unusual
Many other FBT-trained clinicians outside of EDTLA report success with providing FBT-informed treatment to people from all walks of life. One dietitian has reported great progress working with an employed single adult who moved home to live with his parents so they could support him with meals. Sadly, previous providers had pathologized his moving home as a sign of enmeshment. One therapist shared, “I am doing FBT with a 79-year-old. She is now in phase 2. She can now go out on dates—she just has to send pictures of her food to her adult children. They’re taking charge of her recovery and have been in charge of plating her food.”
Many have realized that in-home meal support is a common need for patients, and naturally, it is starting to become a big business with several treatment programs now providing this service. Offered as a service, this individualized meal support can be very expensive. Far more convenient, cost-effective, and loving is meal support provided by parents, other family members, or significant others.
Asking for Help as an Adult is Brave
I personally see it as a sign of strength when an adult admits they need more help. There is no shame in needing meal support during your recovery, no matter what your age. Moving back home to live with family for support is nothing to be embarrassed by. This disorder robs people of their ability to make decisions around food—outside support is needed by definition.
If you struggle around mealtimes with deciding what to eat, only feel safe eating a narrow range of food, have been struggling to make progress in your recovery, or cannot manage urges to purge after eating, you are not alone. You may benefit from the addition of meal support. It may feel scary or embarrassing to ask for help, and you may worry you are being a burden. But asking for help is a brave step, and you will likely find that there are some people in your life who can do this for you. It sometimes requires a little creativity, but you may find that it makes a big difference in your recovery.
The short answer is: Family-Based Treatment can be for people of any age.
Want Effective, Age-Appropriate Support? Learn About FBT for Adults in Los Angeles, CA
Recovering from an eating disorder doesn’t have to be a solo process. Many adults benefit from involving supportive family members or loved ones in treatment. Family-based treatment (FBT) can be adapted for adults by thoughtfully including partners, parents, or other key supports to strengthen recovery, improve accountability, and reduce isolation.
You don’t have to navigate this alone or wonder whether family involvement could help. Through FBT-informed care, individuals and families receive structure, education, and professional guidance to support nutritional restoration, address eating disorder behaviors, and promote lasting change. At Eating Disorder Therapy LA, our Los Angeles–based therapists have experience tailoring family-based and family-involved approaches for adults with anorexia, bulimia, and other eating disorders. Getting started is simple:
- Contact Eating Disorder Therapy LA to talk about whether family-based treatment could support your recovery
- Complete our Google form so we can match you with a therapist experienced in FBT for adults in Los Angeles
- Begin building a recovery process that includes the support you need
Other Therapy Services With EDTLA in California
Recovering from an eating disorder as an adult can feel isolating, especially when support from loved ones feels unclear or underutilized. Family-based treatment (FBT) and family-involved approaches can help adults strengthen recovery by thoughtfully including partners, parents, or other trusted supports in ways that promote accountability, nourishment, and long-term healing.
At Eating Disorder Therapy LA, we provide comprehensive, evidence-based care for adults, college students, adolescents, children, and caregivers. Our clinicians specialize in treating the full range of eating disorders and related concerns. In addition to FBT for adults and teens, we offer therapy for Anorexia Nervosa, Atypical Anorexia, Bulimia Nervosa, Avoidant/Restrictive Food Intake Disorder (ARFID), and Binge Eating Disorder, along with support for concerns such as excessive exercise, body image distress, and phobias related to swallowing, choking, or vomiting.
To meet the diverse needs of our clients, our Los Angeles–based practice offers flexible treatment options, including online therapy and eating disorder group therapy. We also provide Small Group FBT and ARFID consultations, professional speaking engagements, training and educational programs, school-based services, and clinical supervision for therapists seeking advanced expertise in eating disorder treatment and family-centered care.
For additional insight and education, we invite you to explore our Eating Disorder Blog and Dr. Muhlheim’s books, When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders (available in 2026). If you’d like to connect with our team, please call (323) 743-1122 or email Hello@EDTLA.com. We look forward to supporting recovery with the right mix of professional care and meaningful family support.
About the Author
Dr. Lauren Muhlheim, Psy.D., FAED, CEDS-C, is the founder of Eating Disorder Therapy LA and a licensed psychologist with extensive experience providing evidence-based care for eating disorders across the lifespan. Her work focuses on treating anorexia, bulimia, binge eating disorder, ARFID, and related concerns, with particular expertise in family-based treatment (FBT). As one of the few FBT-certified therapists in Los Angeles, Dr. Muhlheim partners closely with parents to support nutrition restoration, guide recovery at home, and help teens resume healthy development. She is the author of When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders, and has created one of the only FBT training courses for dietitians. Licensed in California, Indiana, New York, and Oregon, with a Florida telehealth license, Dr. Muhlheim is widely recognized for her leadership in family-centered, weight-inclusive eating disorder care.