See a video on Maudsley

Here at NBC Chicago. Try not to pay attention to the misleading title, and you will have to watch a short ad before the video loads, and of course there are the usual caveats at the end of the piece. But it seems like a good look at an ordinary family who are helping their daughter through family-based treatment Features Dan Le Grange. I think it's worth a watch.

I just don't get it

It is just shocking to me that so many people misperceive and fear family-based treatment.

I'm no dummy: I know even FBT is no panacea. It won't cure everyone. But it cures a damn sight more folks than anything else we've got. And a lot quicker, too.

So what's the problem? We don't advise against penicillin because some people are allergic to it, do we? We don't dismiss Prozac because hey, it doesn't work for everyone.

So why are people so dismissive of Maudsley? I'm talking about people who haven't worked with it, who are going only by what others say about it.

Maybe it's like a generic medication--there's no big money to be made on it, so there's no incentive to fall in love with it.

But as Daniel Le Grange said to me recently, "We're not doing very well by our children." FBT helps children and adolescents, no question about it. The statistics are very good--80 to 90 percent of those treated with it are still recovered after five years.

FBT doesn't get into cause. It doesn't have an opinion, so to speak, on psychodynamic issues. It rather neatly sidesteps them, at least for phase 1 of treatment--weight restoration.

Is there anyone out there who can truly argue with the need for someone who is severely malnourished to gain weight?

I just don't get it.

6 lessons I learned at NEDA

1. There are lots and lots of well-meaning but ineffectual folks working in the eating disorders field.
2. There is lots and lots of Big Money at stake in the eating disorders field, mostly in the form of residential treatment centers.
3. There are lots and lots of politics in the eating disorders field.
4. Family-based treatment, which the scientific literature recognizes right now as the only evidence-based treatment with an 80 to 90 percent long-term success rate in adolescents, is perceived as controversial in the eating disorders field, even by some of those who profess to support and use it.
5. The most commonly heard comment about FBT at the conference: "Don't you have to be a very special family to make it work?"
6. The intensive outpatient family therapy for eating disorders program at University of California-San Diego, headed by Dr. Walter Kaye, looks absolutely wonderful.

I'm sure there are more, and I'm sure I'll be posting about them too.

Sunday morning at NEDA

The NEDA conference is officially over, but I've still got a bag full of brochures and other stuff I collected here (and I'm not going home until tomorrow morning), so I thought I'd offer another deconstruction of e.d. programs and what they offer to parents.

The reason I'm doing this, by the way, is not just to make enemies (though I'm sure I am) but to try to offer one parent's view of what's on offer. I think it's especially important given a snippet of conversation I had yesterday with one of the long-time NEDA folks, whose comment about Maudsley was, "But you have to be a very, very special family to make that work, don't you?" This is, of course, the mainstream view, and of course it's completely erroneous. It's part of the disempowerment of parents within the eating disorders field that just burns my boat.

So. Within that context, it's not surprising to find brochures like the one I picked up from the Women's Center at Pine Grove, in Hattiesburg, Mississippi, a treatment facility that treats e.d.s, addictions, and both. Here are some of the phrases that jumped out at me from this 12-page glossy brochure: "Components of the treatment experience include understanding the disease process and the camouflaged self, helping women reclaim and celebrate their feminine spirit, empowering women to come to their own assistance. . . . " There's a family week--sounds good, right?--described as "40 hours of intensive therapy where the healing process between family members begins." OK, this center is for women strugglng with addiction as well as e.d.s, and does not seem geared toward adolescents. There are photos of lovely flower arrangements and wooden staircases. Under Amenities, the brochure says, "We offer gender-responsive treatment in a quiet, peaceful, and secluded environment." I'm not sure what gender-responsive treatment means. The next paragraph goes on: "We encourage our patients to take advantage of the nearby YMCA . . . a facility that includes weights, cardiovascular equipment, indoor track and pool, indoor racquetball and basketball course."

Hello? For women in the throes of anorexia?

Nowhere in this brochure is there any mention of food or eating. Nowhere. There is one line under "Components of Treatment" that says "Nutritional counseling." It's about halfway down a list that includes items like "Boundaries & Relationships," "Exercise & Fitness," and "Psychodrama."

I don't think so.