Family Based Treatment: just one more bite to save your child’s life

Compulsive exercise, baggy clothes, thinning hair, dramatic weight loss, preoccupation with food and weight, and denial of hunger. These are only some of the early warning signs that your child may be starving herself and fighting for her life. She is likely fighting off a grave illness, Anorexia Nervosa (AN), the most lethal psychiatric disorder that has possessed her body, like Marvel Comics character, Venom, and overtaken her rational mind. “The mortality rate associated with Anorexia Nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old.1” It afflicts mostly females and is characterized by a pattern of restrictive eating as a result of the preoccupation and fear of gaining weight. It can cause irreparable damage to the body: osteoporosis; cardiac arrest; kidney failure; menstrual dysfunction; anemia; and brain atrophy. Unfortunately only about 1 out of 10 clients with AN seek treatment and only 50% of BIPOC eating disordered clients are likely to be diagnosed or receive treatment.2 Black teenagers are 50% more likely than white teenagers to exhibit bulimic behaviors, such as binge eating and purging.3 Family Based Treatment (FBT) for AN is a highly regarded therapeutic approach that can better serve underserved at-risk populations by reducing the stigma of mental health treatment. 

FBT is an outpatient level of care where the family conducts treatment in their own home and collaborates with other health care professionals including but not limited to a therapist, pediatrician, dietitian, and psychiatrist. FBT is regarded as the gold standard for AN treatment in adolescents and has demonstrated the best prognosis for recovery when early intervention is taken. Under this approach the family and/or caregivers are considered experts of their starved child and their compassionate care is integral for full recovery. Food is the antidote for this life threatening disease. Treatment is divided into 3 phases: weight restoration and reduction of binge eating and purging (phase 1); adolescent control over eating (phase 2); and adolescent identity development (phase 3.) The family provides the medicine, that is, food, to the ill child in their warm, nurturing home and revitalizes her during phase 1. In phase 2, when the client is nourished and has developed a positive relationship with food, she is empowered with the autonomy to make healthy food choices and eat independently. Lastly, in phase 3, the client addresses adolescent identity issues such as body image, depression, and body image. Moreover, there is an establishment of healthy family dynamics. A parent shares advice to families initiating FBT: “Whatever you decide to do, separate the diseases from your child. Your child needs all of your love and support and needs you to help fight the eating disorder. Remain as loving and supportive as you possibly can because your child deserves that from you. It could save his or her life.4For this reason, a residential care program or inpatient hospital is not only costly but it cannot replicate the unconditional love and support of a family. It is paramount that families take action and save their child’s life before it is too late by seeking FBT.