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Therapy With Family Best Approach for Anorexic Girls


WebMD Health News

Dec. 1, 1999 (New York) -- Anorexia nervosa predominantly affects teen-age girls, and can be life threatening. While everyone else may notice the self-starvation, it's often not noticed by the girl herself. Therapy or intervention of some kind is needed but usually the last thing wanted by the sick girl.

Family therapy and individualized therapy with parental involvement have been shown to be effective treatments for adolescent girls in the early stages of anorexia. Now, a new study in the December issue of the Journal of the American Academy of Child and Adolescent Psychiatry shows that family therapy for such patients may be the best and fastest route to greater weight gain as well as more rapid resumption of menstruation.

"Ten years ago, individual therapy was the norm. Then a lot of practitioners started doing family therapy. These days, clinicians typically employ an eclectic combination," lead researcher Arthur L. Robin, PhD, tells WebMD. "We decided to pull those components apart and try to analyze them more carefully." Robin is a professor of psychiatry and behavioral neuroscience at Wayne State University in Detroit.

To look at those compartments, the investigators studied 37 adolescent girls who were beginning to suffer from anorexia. The girls were split into two groups. Girls in one group met weekly with their parents and a therapist; the other girls met with a therapist alone. Both groups were put on a common medical and dietary regimen. Patients were assessed before therapy, after therapy was stopped, and one year later. The girls were checked for body mass index (weight in relation to height), menstruation, eating attitudes, ego functioning, depression, and family interactions.

According to Robin, both family and individual therapy were effective treatments for anorexia, but family therapy rendered faster and greater weight gain. While close to 70% of the girls from both groups reached their target weight by the end of treatment, the girls in family therapy on average showed double the weight gains of the girls in individual therapy. By the one-year follow-up, 80% of those receiving family therapy reached their target weights, as did 70% of those receiving individual therapy. "Girls will gain weight faster and will gain more weight with family therapy," says Robin.

Girls receiving family therapy also resumed menstruation faster than the individual-therapy group.

The therapies were shown to be equally effective when other types of behavior were examined, such as eating attitudes, ability to get along with parents, self-esteem, depression, ego functioning, and desire for thinness, Robin tells WebMD. "My initial hypothesis was that individualized therapy would produce greater changes on ego functioning, depression, and awareness of feelings and so on. That's what individual therapists focus on. I was surprised at the results ... but they could be the result of the measures we used to see changes in ego function."

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