 By LEE BOWMAN Scripps Howard News Service September 04, 2007
"Parents are in a unique position to help their adolescents, yet treatments typically excludes them from the process," said Dr. Daniel Le Grange, lead author of the study, published Monday in the Archives of General Psychiatry. "Now we have the evidence that we need to bring them back in." LeGrange, director of the Eating Disorders Program at the University of Chicago, and colleagues, did a comparative trial involving 80 patients, age 12 to 19, diagnosed with bulimia or with severe symptoms of the disorder, which is characterized by binging on and purging food. Forty-one of the patients were randomly assigned to family-based treatment, the rest to supportive psychotherapy that seeks address issues that may have triggered the disorder. In family-based treatment, parents and sometimes siblings attend clinic sessions with the patient and are trained to take an active role in the home, encouraging healthy eating and monitoring the patients during and after meals. The study showed that 40 percent of teens whose families were included in the treatment program had stopped binging and purging at the end of a six-month treatment session, compared to only 18 percent who received therapy on their own. Six months after the treatment ended, 30 percent of those getting family-based were still avoiding the dangerous eating habits, compared with 10 percent in the psychotherapy group. Bulimia nervosa occurs in an estimated 1 to 2 percent of teens; another 2 or 3 percent experience some symptoms of the disorder, which can also include using inappropriate weight loss methods, use of laxatives and obsessive exercising. In addition to digestive problems, the disorder can cause mineral imbalances in the body that affect the heart and kidneys, swelling of the salivary gland and the loss of dental enamel through repeated exposure to gastric fluids while vomiting. LeGrange said parents of bulimic children have often been made to feel guilty about intervening, "what parent would step aside and play a minimal role in treatment if their child was diagnosed with cancer? Nor should they if a child has an eating disorder." While the family-based approach was more successful, the researchers say it's unclear whether the family involvement or the focus on eat behavior was the most important factor. "We still have work to do in understanding and treating eating disorders," LeGrange said. "While we're happy for how well this approach has done, obvious abstinence rates between 30 and 40 percent leave considerable room for improvement."
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