Your eating disorder impacts your family members, and can also disrupt their daily routines, holidays, and vacations. Family members experience pain and strong emotions while watching you suffer, and often feel powerless. Furthermore, families with an eating disordered individual are often struggling with other addictions, emotional problems, disturbed behaviors, and interpersonal conflicts.
Thus, family therapy, a type of therapy where the entire immediate family participates, is highly recommended as an adjunct to treatment. Family therapy can be used to provide family and loved ones with education, support, communication skills, and conflict resolution. The family therapist can also teach loved ones how to respond to you without trying to control or protect you. Another important aspect of family therapy is teaching members how to have realistic expectations of one another, and reorganizing faulty roles and dysfunctional boundaries. For example, emotional enmeshment, physical intrusiveness, and protective over-involvement must be pointed out and resolved. The family therapist teaches how expectations are communicated and what might be reasonable and achievable. Family members must be provided permission and assistance in developing their own separate and healthy identities. Lastly, a strong, united, and supportive parenting team must be established.
Multifamily groups are an excellent way for families to get extra support during the treatment process. Multifamily groups offer an opportunity for several families to come together to have supportive discussions about what it's like to have someone they love with an eating disorder. It also facilitates understanding as members are able to talk with individuals from other families who have eating disorders. A therapist trained in the treatment of eating disorders facilitates the discussions.
A study published in October 2010 in the General Archives of Pychiatry evaluated the relative efficacy of family-based treatment (FBT) and adolescent-focused individual therapy (AFT) for adolescents with anorexia nervosa in full remission. The study found that there were no differences in full remission between treatments at the end of treatment. However, at both the 6- and 12-month follow-up, FBT was significantly superior to AFT on this measure. Family-based treatment was significantly superior for partial remission at the end of treatment but not at follow-up. In addition, body mass index percentile at the end of treatment was significantly superior for FBT, but this effect was not found at follow-up. Participants in FBT also had greater changes in Eating Disorder Examination score at the end of treatment than those in AFT, but there were no differences at follow-up. The study concluded that although both treatments led to considerable improvement and were similarly effective in producing full remission at the end of treatment, FBT was more effective in facilitating full remission at both follow-up points.
Other adjunctive treatments can also be helpful. For example, guided imagery, relaxation training, and hypnosis are sometimes used to decrease binge episodes in bulimics. These interventions work by decreasing anxiety, coping with negative emotions, and reducing impulsiveness. These strategies are practiced as a substitution for binge eating behaviors.
In addition, psychiatric medications are prescribed in some cases to control the symptoms of eating disorders and co-morbid conditions, although medications cannot cure or entirely eliminate any eating disorders. Certain forms of antidepressants (SSRI's) have been shown to decrease binging in bulimics; and help to restore weight and prevent relapse in recovered anorexics. Also, appetite stimulants can help to boost treatment in some anorexics and bulimics. Anti-anxiety and antipsychotic medications (which help to stabilize mood and clear thinking) have been shown to be especially effective for anorexics who have high levels of anxiety and obsessive thinking.