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Family-Empowered Treatment in Higher Levels of Care for Adolescent Eating Disorders: The Role of the Registered Dietitian Nutritionist

      Family-based treatment (FBT) is the leading evidence-based treatment for adolescents with eating disorders,
      National Institute for Health and Care Excellence
      Eating Disorders: Recognition and Treatment. Version 2.0. Full Guideline.
      and has particularly strong research support for the treatment of anorexia nervosa (AN).
      • Lock J.
      • Le Grange D.
      Treatment Manual for Anorexia Nervosa: A Family-Based Approach.
      FBT is an outpatient treatment consisting of 3 phases.
      • Lock J.
      • Le Grange D.
      Treatment Manual for Anorexia Nervosa: A Family-Based Approach.
      In phase 1, because patients with AN are often ambivalent about treatment and recovery, parents are given the responsibility for weight restoration. This involves making all eating-related decisions for their child, including deciding what will be eaten and when, how much will be eaten, monitoring all meals and snacks, and curtailing physical activity. Once the patient has gained weight, eating disordered behaviors have lessened, and the adolescent’s thoughts and behaviors are no longer being driven by the eating disorder, responsibility for eating is gradually handed back to the adolescent—to whatever extent is age-appropriate—in phase 2. In phase 3, the treatment team ensures that the adolescent is back on track with healthy development. FBT has also been found to be effective for bulimia nervosa.
      • Le Grange D.
      • Lock J.
      • Agras W.S.
      • Bryson S.W.
      • Jo B.
      Randomized clinical trial of family-based treatment and cognitive-behavioral therapy for adolescent bulimia nervosa.
      Although the phases of treatment are the same for bulimia nervosa, the focus of treatment is on developing a regular pattern of eating and eliminating binge eating and purging.

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      Biography

      J. Patterson is a virtual nutrition manager, Eating Recovery Center, Denver, CO.

      Biography

      J. L. Myers is a Clinical Dietitian II, Eating Recovery Center, Denver CO.

      Biography

      E. Gallagher is a Clinical Dietitian II, Eating Recovery Center, Denver CO.

      Biography

      G. R. Hartman is a senior clinical dietitian, Eating Recovery Center, Denver CO.

      Biography

      J. Bush Lewis is a nutrition director, Eating Recovery Center, Plano TX.

      Biography

      C. Royster is a nutrition manager, Eating Recovery Center, Hunt Valley, MD.

      Biography

      E. Easton is national director of psychotherapy, Eating Recovery Center and Pathlight Mood and Anxiety Centers, Denver, CO.

      Biography

      A. O’Melia is chief medical officer and chief clinical officer, Eating Recovery Center and Pathlight Mood & Anxiety Centers, Denver, CO, and an adjunct associate professor, University of Utah, Salt Lake City, UT.

      Biography

      R. D. Rienecke is director of research, Eating Recovery Center and Pathlight Mood & Anxiety Centers, Chicago IL, and an adjunct associate professor at Northwestern University, Chicago, IL.