If your teenager has anorexia, her treatment is likely to be challenging. Any sort of disorder that starts when a person is young is going to be difficult to treat and recover from, says Dr. David Schlager, psychiatry professor at Texas A & M University. Anorexia is particularly tough to treat. When a teen is severely underweight, she tends to have trouble concentrating and reasoning. With anorexics, typical 12-step programs probably won’t work because they require a person to acknowledge her illness, which many anorexic teens do not do. It is possible, even critical, to treat anorexia; a person can’t get over it on her own.
Traditionally, individual counseling has been the standard treatment method for anorexic teens. This therapy focuses on the teen’s anxieties and emotional problems. The doctor may admit the patient into the hospital. Patients can gain weight there, but they tend to lose it again once they get home, says Dr. James Lock, psychiatry professor at Stanford University and one of the lead researchers in an October 2010 study published in the “Archives of General Psychiatry.” In individual psychotherapy, parents are also to blame for their teen’s condition, which is another reason doctors admit the anorexic patient to the hospital — to remove the teen from a toxic environment.
The Lock study suggests that family-based treatment is twice as effective as traditional individual-based psychotherapy. Rather than blaming the parents, family-based therapy allows parents to be involved in the treatment. Family-based therapy teaches family members how to understand and help find solutions for their child’s eating and over-exercising problems. The patient learns how to eat at home, rather than learning in a hospital environment, and then tries to emulate the behavior at home.
With family-based therapy, the focus is on teaching parents how to help their anorexic child learn how to start eating again, help them gain weight and ensure that the overexercising stops. As the patient makes improvements, the therapy also teaches parents how to let go and give the child more autonomy. Disrupting the way an anorexic thinks is part of the battle. Even healthy people obsess about food when they are starving. Once you get an anorexic to eat, you disrupt the obsessive thought patterns, says Lock.
Individual and family-based therapies both have the same initial success rates. Success indicates that patients in treatment achieve normal or close-to-normal weight. The difference is in the relapse rates. According to the Lock study, after six months, 40 percent of patients in family-based therapy remained in remission, but only 18 percent of those in individual therapy stayed in remission. After a year, 49 percent of the family group stayed in remission, but only 23 percent of the individual group stayed.
Seek Treatment Early
Another finding regarding treatment is that — like many illnesses — the earlier you seek treatment, the better, whether the treatment is individual- or family-based. In fact, while the numbers favor family-based therapy, some patients fare better with individual psychotherapy. Lock said in a Stanford University press release that the next step is determining which types of patients would do better with each therapy.