Abnormal Eating Patterns Research Articles

A Family Systems Orientation to the Treatment of Anorexia Nervosa

A collaborative child psychiatric-pediatric team approach is described for the evaluation and treatment of anorexia nervosa. The first step is an obligatory medical evaluation to confirm the diagnosis and to determine the need for inpatient or outpatient therapy. The use of operant reinforecemnt paradigms within the framework of structural family therapy has proven effective and avoids the use of medication, nasogastric intubation, and hyperal-imentation to achieve weight gain. The inpatient phase is an intense, short-term (3–4 week) process aimed at correcting abnormal eating patterns and initiating family therapy with lunch sessions. Early direct involvement of the family promotes more consistent weight gain. The outpatient phase consists of continued family therapy and, when indicated, gradual transition to marital therapy for the parents and individual psychotherapy for the patient. This facilitates continued changes in the structure and functioning of the family and patient necessary to prevent relapses and foster continued development.