New research suggests it could be beneficial to get parents more involved in a teen's bulimia treatment.
A recent study was the largest randomized clinical trial for adolescents with bulimia nervosa, the University of California, San Francisco reported. The findings contradict the way clinicians are historically trained to treat young people struggling with bulimia in which parents are excluded from counseling.
"Parents need to be actively involved in the treatment of kids and teens with eating disorders," said Daniel Le Grange, Benioff UCSF Professor in children's health in the departments of psychiatry and pediatrics at UCSF Benioff Children's Hospital San Francisco. "This study shows definitively that parental engagement is imperative for a successful outcome of adolescents with bulimia nervosa. It goes counter to the training that physicians receive in psychiatry, which teaches that parents are to blame for bulimia, and therefore should be omitted from treatment."
The study compared cognitive behavioral therapy (CBT) and family based therapy (FBT) to determine which route was more effective. CBT focuses on the individual patient, and helps the individual understand and confront the irrational thoughts that are causing them to binge and purge, while FBT trains a patient's parents to best support them. The findings showed patients participating in family based therapy achieved higher abstinence rates from binging and purging than those undergoing CBT alone. Following initial treatment, 39 percent of FBT patients were abstaining from binging and purging compared with only 20 percent of CBT patients. At the six-month follow-up period, 44 percent of FBT patients were abstaining from binging and purging versus 25 percent of CBT patients; after a year, abstinence rates were at 49 percent for FBT patients and 32 percent for CBT patients.
"These findings are quite clear," Le Grange said. "FBT is the treatment of choice for adolescents with bulimia nervosa, because it works quicker and faster and maintains its impact over time. CBT could be a useful alternative if FBT were not available, but it needs to be recognized that it doesn't work quite as fast and takes time to catch up,"
The findings were published in a recent edition of the Journal of the American Academy of Child and Adolescent Psychiatry.