Beyond Simple Solutions: The Need for Complex Ideas in Anorexia Nervosa

I often hesitate to make broad, sweeping claims about the nature, cause, and experience of eating disorders and disordered eating. However, if there is one thing I feel absolutely certain saying about these disorders, it is that they are incredibly complex and multifaceted with no “one-size fits all” solution. So, I was quite excited when I came across a recent article by Michael Strober and Craig Johnson (2012) that explores the complexity of eating disorders and their treatment. Both authors have significant clinical experience treating eating disorders.

This article uses cases studies, literature, and the authors’ collective clinical experience to respond to some of the key controversies surrounding anorexia and its treatment. Among the major controversies that have come to light of late, they focus on two:

  1. Genetic/biological causation (Biologically-based mental illness – BBMI)
  2. Family-based treatment (FBT) as the best form of treatment for adolescents

The authors’ exploration of these … Continue reading →

Family-Based Treatment for Adolescents with Anorexia Nervosa: Hype or Hope?

When it comes to eating disorder treatment, few (if any) approaches are as divisive as Family-Based Treatment, also known as the Maudsley Method (I’ll use the terms interchangeably) . When I first heard about Maudsley, sometime during my mid-teens, I thought it was scaaary. But, as I’ve learned more about it, I began to realize it is not as scary as I originally thought.

As a side-note: I know many people reading this post know more about Maudsley than I ever will, so your feedback will be very much appreciated, especially if I get something wrong. I should also mention that I never did FBT or any kind-of family treatment/therapy as part of my ED recovery. (I have done family therapy, but it was unrelated to my ED; it was a component of a family member’s treatment for an unrelated mental health issue.)

In this post, I want to … Continue reading →

How Can We Treat Chronic and Severe Anorexia Nervosa? (On the Need for New Approaches)

Treating anorexia nervosa is hard. Treating chronic and severe anorexia nervosa is a lot harder. Although the situation seems to be improving, there are really no evidence-based treatments for anorexia nervosa – particularly for those who have been sick for a long time.

Patients with severe and enduring anorexia nervosa have one of the most challenging disorders in mental health care  (Strober, 2010).They have the highest mortality rate of any mental illness with markedly reduced life expectancy (Harbottle et al., 2008). At 20 years the mortality rate is 20%, and given the young age of onset this results in many young adults dying in their 30s, and a further 5–10% every decade thereafter (Steinhausen, 2002)… Patients are often under- or unemployed, on sickness benefits, suffer multiple medical complications… have repeated admissions to general and specialist medical facilities, and are frequent users of primary care services (Birmingham and Treasure, 2010;

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