Study: Parents Can Make A Difference With Anorexic Teens Treating anorexia nervosa in teens can be difficult and challenging. The stakes are high: These children often have to be hospitalized to get better, and some even die from the disease. But in a new study, researchers report long-term success for teens who had intense family-based treatment.

Parents Can Make A Difference With Anorexic Teens

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There may be a new way to treat a disease that's been devastating to generations of teenagers - anorexia nervosa. Children often have to be hospitalized to get better. Some even die. In the October issue of the Archives of General Psychiatry, researchers report long-term success for teens who undergo intense, family-based treatment. NPR's Patti Neighmond explains.

PATTI NEIGHMOND: For decades, doctors have been struggling to come up with a really successful way to treat anorexia patients. Now, they think they may have one. Psychologist Daniel Le Grange is one of the authors of this new study.

Dr. DANIEL LE GRANGE (University of Chicago Medical Center): We can much more confidently say that a teenager with anorexia nervosa who is medically stable should, as a first-line treatment, receive family-based treatment.

NEIGHMOND: Family-based treatment turns traditional therapy on its head. In the past, doctors tried to treat the underlying causes of anorexia, and the family was often pushed to the side. But in family-based treatment, the emphasis is on weight gain first, and it's the parents who take the pivotal role.

Dr. LE GRANGE: No one is more available to care for their kids than parents are; no one would put the time aside in the way that parents would; and no one loves their children more than parents do.

NEIGHMOND: Le Grange directs the Eating Disorders Clinic at the University of Chicago Medical Center, one of the study sites where 120 teenagers were divided into two groups. One group received traditional, one-on-one therapy. The other received family-based treatment, which was first taught to their parents by experts like Le Grange.

Dr. LE GRANGE: The parents have to be coached that they are making the decisions about how much the teen needs to eat in order to recover. The decisions are theirs, the timing of the meals are theirs, the preparation of the food are theirs. And they put it in front of the patient and say, this is difficult for you, but you have to eat this. And I'm going to sit here with you until you can.

NEIGHMOND: No matter how long it takes, parents literally sat with their teenager until all the food was gone for each and every meal and snack.

One of the teenagers in the study who received this type of treatment was Rina Ranalli's 12-year-old daughter.

Ms. RINA RANALLI: We would start eating, and there would be the usual, I'm not going to have this, there's no way, I'm not - you know, the usual defiance. And then we were as calm as we could be, and we would simply say over and over, this is your medicine, we're not leaving, you're going to be safe, its going to be okay, you're going to get through this, we're going to be here with you. And suddenly the - you know, the forks would go to the mouth, and it would happen.

NEIGHMOND: As her daughter began to put on weight, psychological problems associated with anorexia - like depression, anxiety and isolation - also began to diminish until finally, after nearly a year, her daughter was once again healthy.

Ms. RANALLI: She actually likes food, and its great. It's great to have her back, and its great to be able to watch her grow up.

NEIGHMOND: Over the past few years, an increasing number of doctors and therapists are initiating this type of family treatment. Psychologist Sari Shepphird specializes in eating disorders. She says it makes much more sense to tackle the weight gain first.

Dr. SARI SHEPPHIRD (Psychologist): If there are underlying issues of anxiety or perfectionism, which is a chronic trait in those that we find with anorexia nervosa, we do address those in psychotherapy. But instead of addressing them first and putting weight restoration on the back burner, we have now flipped the order, and we focus primarily on weight restoration. And then the person is strong enough and in a better position to be able to address the underlying issues that exist.

NEIGHMOND: While both individual and family therapy did help most kids in the study get back to normal weight within a year, the teenagers who had family therapy were far more likely to stay healthy. One year after treatment, only 10 percent of them relapsed, compared to 40 percent of kids who got individual therapy.

Patti Neighmond, NPR News.

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