What is Family-Based Treatment and How Does It Support Teen Eating Disorder Recovery?

Written by Cristina Luibil, MS, RD, LDN with support from Sabrina Stadelman.

If your teen has been diagnosed with an eating disorder, you will likely be experiencing many emotions. You may be feeling scared, overwhelmed, confused, or wondering what your role in their recovery will be and what you can do to help them. There are many ways in which you can support your teen and even take an active role in their recovery. Whether you have heard of Family-Based Treatment or not, it can be an effective treatment option for your teen. 

What is Family-Based Treatment and How Does It Support Teen Eating Disorder Recovery?

When possible, Family-Based Treatment (FBT) is the best option for teens in eating disorder recovery. FBT is an evidence-based treatment plan that places parents and caregivers at the center of treatment. Families receive support from a treatment team. This team includes an ED specialist dietitian, therapist, psychiatrist, and physician. FBT supports teen recovery because it prevents family separation during recovery. 

FBT allows parents and caregivers to have input. It creates a more effective treatment plan by involving family members in treatment decisions. It also helps teens to be in a more familiar environment with their family during recovery.

There are 3 phases of Family-Based Treatment:

Phase 1: Full parental control and involvement in preparing, plating, and serving the teen food. Parents must watch their teen at meals to ensure the teen is eating all their meals and snacks. The teen’s only “job” during this phase is to eat all their meals and snacks. 

Phase 2: Gradually gives the teen a bit more autonomy in the eating process. Starting phase 2 depends on the teen’s nutritional, psychological, and medical stability. The level of input the teen gets in the eating process depends on a conversation between them, their dietitian, and parents. 

Phase 3: The teen can start plating their own meals and snacks. They will have less monitoring during meals. They will still follow a recovery meal plan and their dietitian will recommend any changes as the teen continues on through this process. 

What if My Family Cannot Commit to the Full Scope of FBT during teen eating disorder recovery?

Whether due to work/school schedules, other necessary obligations, or because your teen wants (and is capable of) more agency in their treatment, at Aterra Nutrition we take an FBT-informed approach to the nutrition side of things. This means we meet the teen and their family where they are in terms of how “regimented” families’ roles are. If the teen has expressed wanting more agency in their treatment, we will try it out and honor that. However, we are always cognizant of the eating disorder voice speaking for the teen, and we assess each situation with care. We also meet parents where they are in terms of their capacity for involvement. In our experience, we have found that we are able to better help our families if we take into account realistic family barriers. We work with you to make FBT work for your family rather than only following the more strict or “manualized” FBT regimen.

FBT is effective because it allows parents and caregivers to take an active role in their teen’s recovery. Remaining in a familiar environment (at home) helps to make recovery less traumatic for teens and families. It also provides teens with a family support system throughout their eating disorder recovery.

Eating disorder recovery is difficult and it is normal if this all seems overwhelming, but taking an FBT approach will be beneficial for you teen and family. Throughout their life, you as a parent or caregiver are and will continue to be a support system for your teen, and this shouldn’t change in eating disorder recovery. By taking an FBT approach, you can work with a treatment team to make recovery work best for your teen and your family environment, and to provide your teen with the best support possible throughout their recovery. 

If you’re looking for support for a teen struggling with an eating disorder, Aterra Nutrition offers virtual nutrition counseling and support for eating disorder recovery with a registered dietitian. We offer one-on-one nutrition counseling for those in DC, Maryland, Virginia, New Jersey, and Michigan. Learn more about the eating disorder services Aterra Nutrition offers on our website at aterranutrition.com.

About the Author

Cristina Luibil, MS, RD, LDN specializes in eating disorder recovery and Intuitive Eating for teens and adults. Aterra Nutrition provides virtual nutrition counseling for those in DC, Maryland, Virginia, New Jersey, and Michigan. This post was researched and written in conjunction with Sabrina Stadelman, dietetics student and nutrition assistant at Aterra Nutrition. Learn more about the whole team at aterranutrition.com/about.

Disclaimer: The information shared in this blog is for general educational and informational purposes only. It may not be tailored to your specific health needs as it is written here. This content is not intended to replace personalized medical advice, nutrition counseling, or medical nutrition therapy. Any recipes or suggestions provided are meant to inspire and should be used at your discretion. Always consult with your own registered dietitian, physician, or healthcare provider before making changes to your nutrition, lifestyle, or treatment plan. If you choose,

If you have other nutrition and Intuitive Eating goals for you or the entire family, our sister company, Radica Family Nutrition, would love to help.