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Eating & Body Image Problems

Created on August 5, 2017. Last updated on October 13th, 2022 at 09:07 pm

Take me to the effective therapies for eating disorders

Many children and teens worry about their eating, weight, or body shape. But for some children and teens these worries can lead to unhealthy eating or dieting, known as eating disorders. It is important to get children with eating disorders early evidence-based treatment because many disorders can lead to serious, even life-threatening medical problems.

What are Eating Disorders?

Eating disorders are caused by strange eating behaviors. These behaviors are usually harmful ways to control body shape or weight, and cause the child to view his or her own body in a negative way. There are a variety of eating disorders, including:

  • Anorexia nervosa
  • Avoidant/restrictive food intake disorder
  • Binge eating disorder
  • Bulimia nervosa
  • Pica
  • Rumination disorder

Effective Therapies for Eating Disorders

Doctors have found certain treatments are the most helpful for children with eating disorders.

  • For anorexia nervosa and bulimia nervosa, research shows that family-based treatment—also known as Maudsley family therapy—works well.
  • Binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID) were only recently identified as eating disorders. Because of this, no child and adolescent therapies have yet been shown to work well. However, current research shows that cognitive-behavior therapy and family-based treatment might work for BED and family-based treatment might work for ARFID.

 

Tested Therapies for Adolescent Anorexia Nervosa
Level One:
Works Well
Level Two:
Works
  • Family therapy-systemic
  • Insight-oriented psychotherapy (individual)
  • Adolescent-focused therapy (individual)
  • Parent-focused therapy
Level Three:
Might Work
  • Guided self-help, telephone assisted therapy (Experienced Carer Helping Others, or ECHO)
  • Family-based treatment + cognitive remediation training and family-based treatment + art therapy
Level Four:
Experimental
  • CBT – broad (individual)
  • Cognitive remediation training (individual)
  • Family-based treatment – intensive parental coaching
  • DBT skills group
  • Family-based treatment + DBT skills
  • Family-based treatment – guided self-help for waitlist
Level Five:
Tested and Does Not Work
  • Outpatient family therapy with/without family meal

To find out more about how these treatment levels are defined, click here.

Therapies and Terms Defined:

  • CBT: cognitive behavioral therapy
  • Family therapy-behavior, also called family-based treatment (FBT) and Maudsley family therapy
  • DBT: dialectical behavior therapy

Source(s): Datta, N., Matheson, B.E., Citron, K., Van Wye, E.M., & Lock, J.D. (2022). Evidence based update on psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, DOI: https://doi.org/10.1080/15374416.2022.2109650

 

Tested Therapies for Adolescent Bulimia Nervosa
Level One:
Works Well
Level Two:
Works
  • None
Level Three:
Might Work
  • CBT – guided self-help (individual)
Level Four:
Experimental
  • CBT (individual)
  • Supportive psychotherapy (individual)
Level Five:
Tested and Does Not Work
  • Guided self-help – waitlist

To find out more about how these treatment levels are defined, click here.

Therapies and Terms Defined

  • CBT: cognitive behavioral therapy

Source(s): Datta, N., Matheson, B.E., Citron, K., Van Wye, E.M., & Lock, J.D. (2022). Evidence based update on psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, DOI: https://doi.org/10.1080/15374416.2022.2109650

 

Tested Therapies for Binge Eating Disorder
Level One:
Works Well
  • None
Level Two:
Works
  • None
Level Three:
Might Work
Level Four:
Experimental
  • IPT (individual)
  • DBT (individual and family)
Level Five:
Tested and Does Not Work
  • None

To find out more about how these treatment levels are defined, click here.

Therapies and Terms Defined

  • CBT: cognitive behavioral therapy
  • IPT: interpersonal psychotherapy
  • DBT: dialectical behavior therapy

Source(s): Datta, N., Matheson, B.E., Citron, K., Van Wye, E.M., & Lock, J.D. (2022). Evidence based update on psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, DOI: https://doi.org/10.1080/15374416.2022.2109650

 

Tested Therapies for Avoidant/Restrictive Food Intake Disorder
Level One:
Works Well
  • None
Level Two:
Works
  • None
Level Three:
Might Work
Level Four:
Experimental
Level Five:
Tested and Does Not Work
  • None

To find out more about how these treatment levels are defined, click here.

Therapies and Terms Defined

  • CBT: cognitive behavioral therapy

Source(s): Datta, N., Matheson, B.E., Citron, K., Van Wye, E.M., & Lock, J.D. (2022). Evidence based update on psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, DOI: https://doi.org/10.1080/15374416.2022.2109650

Partner Sites:

Evidence-based Services Committee of Hawaii