Last chance!

Tomorrow is the last day to get the conference room rate for the one-day conference on child and adolescent eating disorders in Pearl River, NY, sponsored by Maudsley Parents. This fabulous one-day conference features some of the top experts in the field talking about how to recognize and treat eating disorders in children and teens:

• Debra Katzman, MD, will talk about where we stand with child and adolescent eating disorders
• Rebecka Peebles, MD, will talk about the medical side of treating child and teen EDs
• Katharine Loeb, MD, will talk about early interventions--what, why, and how
• Daniel le Grange will talk about working with families from both a therapist and parent perspective
• Evelyn Attia will talk about whether there's a role for medication in treating children and teens with EDs

This is going to be a truly remarkable conference, and I hope you can join me and my co-chair at Maudsley Parents, Jane Cawley on Friday, February 17, at the beautiful Hilton Pearl River hotel.

See you there!

Come talk to me!

Thanks to Maudsley Parents and the University of Chicago for hosting an evening with Dr. Daniel le Grange and myself at University of Chicago on October 20th. This is your chance to meet up with other families who may have dealt with eating disorders, to learn from them, and, most important, to not feel isolated or alone.

This event is free, thanks to the generous sponsorship of Maudsley Parents, but you must RSVP to reserve a place: RSVP@maudsleyparents.org.

I hope to see you there!

San Diego Conference

I'm sitting in the San Diego Airport, having gotten here at an ungodly hour for my flight back to NY. But I don't mind, because yesterday's Maudsley Parents conference was a great success.

The conference sold out, and our room was packed with a dynamic mix of clinicians and families.
The always cerebral Dr. Walter Kaye opened the conference with a friendlier-than-usual exploration of the neurobiology of eating disorders. Next up was Dr. Daniel leGrange of the University of Chicago, who took us through the history of research on eating disorders (distressingly meager) and explained in great detail the history of family-based treatment.

After lunch, we heard from Dr. le Grange and Dr. Renee Hoste, also of the University of Chicago, on clinical applications of the research. Last but not least, Roxie Rockwell of University of California-San Diego explained UCSD's wonderful week-long multi-family intensive program. (All PowerPoint slides are up on the Maudsley Parents website.)

Kudos to the main conference organizer, my partner-in-crime at Maudsley Parents, Jane Cawley, who by now really knows how to put on a great day.


And thanks to everyone who participated and attended. We're thinking New York City for our next conference. Stay tuned!

Maudsley Parents conference: San Diego, Jan. 21, 2011

For those of you on the West Coast (or those who wouldn't mind a sunny interlude in January), Maudsley Parents is pleased to announce that registration is open for our next conference, scheduled for Jan. 21, 2011, in San Diego.

The fabulous lineup for this one-day conference includes a talk on the neurobiology of eating disorders by Dr. Walter Kaye of the University of California-San Diego; a talk on family-based treatment (FBT) by Dr. Daniel le Grange of the University of Chicago; an interactive session on FBT by Dr. le Grange and Dr. Renee Hoste, also of University of Chicago; and a dynamic presentation on multi-family treatment for eating disorders by Roxanne Rockwell, the lead therapist at the University of California-San Diego's Eating Disorders Program. I've worked with all of these professionals, and they're amazing. I'll also be doing a reading from my book, Brave Girl Eating.

Register before November 30 and get the early bird rate of only $60 for a day full of education (and lunch!). For more information, click here. Hope to see you in San Diego!

Conference in Chicago--register now!

In just over two weeks Maudsley Parents will sponsor its second conference on eating disorders--this time in Chicago. This one-day conference, aimed at parents, therapists, and researchers, features some of the best thinkers on eating disorders in the country--including Dr. Daniel le Grange and Dr. Walter Kaye—plus a panel of parents who will talk frankly about what they know about combating their children's eating disorders.

It's going to be a fabulous event. I'll be there, along with my two partners in crime from Maudsley Parents--Jane Cawley and Ann Farine. We've worked hard to keep it affordable so everyone who wants to come can manage it.

For more information or to register, click here. We'd love to see you in Chicago!

Chicago conference! April 26!

If you're in the Chicago vicinity (or even if you're not), please join Maudsley Parents for a day-long conference featuring some of the smartest and most articulate researchers in the field of eating disorders.

Our speakers include Dr. Walter Kaye, director of the University of California San Diego's Eating Disorders Program, and Dr. Daniel Le Grange, director of the University of Chicago's Eating Disorders Program. They're two of my all-time favorite experts, and they'll have some exciting new research results to share. We'll also have a panel of parents who will share their experiences using Family-Based Treatment (FBT) to help their children recover from eating disorders.

Register here before Feb. 28 and the fee is only $40. After March 1, the fee is $50.

I'll be there--I hope to see you!

See you in . . . October?

For those of you in the D.C. area, I hope you'll join me and some very special guests at a conference on eating disorders, hosted by Maudsley Parents. This half-day get-together features two of the leading researchers in the field of eating disorders, both of whom are accessible, compelling speakers. Daniel le Grange heads up the University of Chicago's Eating Disorders Program; Walter Kaye directs the University of CalIfornia-San Diego's program.

Dr. le Grange will discuss family-based treatment (the Maudsley approach) for both anorexia and bulimia. Dr. Kaye will give us insights into the neurobiology of eating disorders. And I'll share my family's story and offer parents specific strategies and tips for helping a child through an eating disorder.

You can find more information and sign up for the conference here. (If you sign up before September 14, the cost is only $25 per person.) I hope to see you there!

Help for bulimia

I know from personal experience how family-based treatment (FBT, also known as the Maudsley approach) can work in treating anorexia. I'm thrilled that the evidence is mounting for its effectiveness with bulimia, too, especially for teens with bulimia.

But don't take it from me! Maudsley Parents has been putting together information on bulimia and its treatment, which you can see here.

Both Stanford University (where Dr. Lock teaches and researchers) and the University of Chicago (where Dr. le Grange is based) are recruiting teens for bulimia studies right now.

Here's a video of Dr. James Lock, who literally wrote the books (along with Daniel le Grange) in the U.S. on FBT, talking about bulimia:

The Maudsley Institute

It's not really called that, but that's how I think of the new training program for Maudsley therapists, organized and run by Drs. Daniel le Grange and James Lock, co-authors of Help Your Teenager Beat an Eating Disorder. Its official name is the Training institute for Child and Adolescent Eating Disorders, and it aims to do something incredibly important: train therapists to do true family-based treatment.

Right now, many families in the U.S. who want to use family-based treatment to help their children recover from eating disorders face the unhappy choice of trying to go it alone, drive many hours to see a Maudsley therapist, or go with a different treatment. FBT is hard--the hardest thing most families will ever do. They need support. But at the moment, there just aren't enough true Maudsley providers to go around.

Maybe more important, families have no way to tell the faux Maudsley providers from those who truly practice and believe in FBT. There's a surprising number of therapists out there who say they practice Maudsley but who've given it their own unfortunate spin, like this one. And there are outpatient and inpatient programs who claim the same. Too often, what they're doing is NOT true FBT.

Lock and le Grange's new institute will put the seal of approval, as it were, on professionals who not only train with them but actually practice true FBT. This is good for everyone: Providers will get more training from the folks who know the treatment best, and families will have a measure by which to judge quality and competence of potential therapists. It's win-win.

The first training will be held February 27-28 in Palo Alto, California. It will take some time to "graduate" the first group of Maudsley therapists. Personally, I can't wait. Thanks to Drs. le Grange and Lock for doing this.

Why we need to talk about food

Over at Laura Collins' blog there's a compelling debate raging about treatment for eating disorders. It started with a link to a Student Doctor Network discussion about Maudsley (also known as family-based treatment).

The forum link is a peek into the minds of some medical/psych students who dismiss Maudsley treatment as something that might work only for "the very tame cases" (has anyone out there ever seen a "very tame case" of anorexia?). Students who know nothing about it say confidently that they would "never recommend it."

I would think that given the truly abysmal rates of recovery from eating disorders, medical professionals would be thrilled to learn about a treatment with positive results and an excellent track record. I've got a couple of suggestions for where to start: With this useful Q&A on Maudsley and this article about the University of Chicago's Daniel Le Grange.

And in answer to a comment made on the Student Doctor Network, I love what Dr. Le Grange says at the end of the article: "How can you not talk about food when your daughter is starving?"

Mom's off the hook, Dad's on the hot seat

For the last 60 years or so, parents have been blamed for their children's eating disorders. Doctors have believed, and said, that anorexia and bulimia are caused by overcontrolling parents, by abusive parents, by sexual trauma, by inattentive parents, by cold parents, hypercritical parents. New research on the biology of eating disorders has slowly begun to offer an alternative to the blame game--a combination of genetics, biology, and environment is probably responsible for eating disorders, or so goes the latest thinking. (Though some folks clearly have some catching up to do on this score.)

Now a study from Australia points the finger once more at parents--specifically fathers, who are charged with contributing to a child's anorexia when they exert too much control. Mothers, on the other hand, played no apparent role.

I haven't read the original study, but the article reporting it makes me wonder how, exactly, this data was gathered. Reading between the lines, it seems the descriptions of the paternal relationships were reported by the teens with anorexia. Well, they'd have to be, wouldn't they?

Anyone who's parented a teen with anorexia knows that someone in the grip of an eating disorder may reflect a lot of anger toward parents, especially if those parents are insisting that the teen eat. It's really not the teen talking but the disease, which famously warps perceptions and behaviors.

While I'm sure there are overcontrolling fathers out there who contribute to their child's unhappiness in various ways, I'm a little leery of this kind of thing being reported as fact in a scientific study--and of what may come of it down the line.

As Daniel Le Grange once pointed out to me, by the time families come in for help with a teen's eating disorder, they tend to look pretty overcontrolling, because they're terrified at their child's behavior and frightened for her/his health and life. So even if the observations are made by someone outside the family, I wonder how meaningful observations made in a time of family crisis really are when thinking about causation.

God knows we need more studies about anorexia and bulimia--the lack of them is in part responsible for the dreadful lack of effective treatment options. I just wonder if this is the best use of research dollars. Wouldn't the money and time be better spent looking at ways to help teens recover rather than blaming their parents?

Um, just a thought.

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.