When Your Child is Anorexic
How active you are may be the key to effective treatment.
May 1, 2000 (Corralitos, Calif.) -- For years, parents of anorexic girls have been told to avoid arguments over food and give up their failed fight for control over their daughters' bodies. But when Claire and Bob Donovan walked through the doors of Children's Hospital of Michigan with their bone-thin daughter Megan, they were put squarely in charge.
Megan had starved herself down to 85 pounds. To save her life, therapists said, her parents would have to dispense food as if it were a prescription drug. They would gently but firmly tell her to rest in bed when she didn't eat. And they would reward her with trips to the mall when she did. Later, as Megan's health returned, they would begin to let go of their little girl and give the 17-year-old greater independence in choosing her college and spending time with friends.
Using parents as tools in treating adolescent anorexia is a radical new approach being discussed and taught this week, May 4 through 7, at the 9th International Conference on Eating Disorders in New York City. The conventional wisdom has been that family conflict sets the stage for teenage eating disorders, so therapists usually counseled parents to steer clear and allow teens to take charge of their recovery. But a growing number of therapists, like Megan's, say that specially trained parents are perhaps the most effective cure -- and recent research backs them up.
Giving Food as Medicine
"These young girls are out of control when they come to see us. They are not able to take charge of anything," says Patricia T. Siegel, PhD, a pediatric psychologist at Children's Hospital in Detroit. Siegel discussed Megan's case with WebMD, but changed the family members' names to protect their privacy. "We told Megan's parents that their child was sick -- that she could not make herself better any more than if she had a cardiac problem. We put the parents in charge of giving their daughter her medicine. In this case the medicine was food."
This approach to treating anorexia made headlines six months ago after Arthur L. Robin, PhD, published findings of a long-term study in the December 1999 issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Robin, a professor of psychiatry and behavioral neurosciences at Wayne State University, and his colleagues followed 37 girls. Eighteen of them were treated in individual therapy sessions; their parents were counseled separately and told to give up cajoling or ordering their daughters to eat. The other 19 girls and their parents met jointly with therapists who put the parents in charge of their daughters' eating.
The majority of girls in both groups responded well to treatment: 70% reached their target weight. But the girls whose parents were trained to oversee their food gained weight faster and gained more weight. One year later, even more of those girls had reached healthy weights.