An Exploratory Evaluation of the Family Meal Intervention for Adolescent Anorexia Nervosa

• Author: Cecile Rausch Herscovici,Liliana Orellana,Irina Kovalskys
• Date: 01 June 2017
• DOI: http://doi.org/10.1111/famp.12199
• Published date: 01 June 2017

An Exploratory Evaluation of the Family Meal

Intervention for Adolescent Anorexia Nervosa

CECILE RAUSCH HERSCOVICI*

IRINA KOVALSKYS*

LILIANA ORELLANA

†

Although weight restoration is a crucial factor in the recovery of anorexia nervosa (AN),

there is scarce evidence regarding which components of treatment promote it. In this paper,

the author reports on an effort to utilize research methods in her own practice, with the

goal of evaluating if the family meal intervention (FMI) had a positive effect on increasing

weight gain or on improving other general outcome measures. Twenty-three AN adoles-

cents aged 12–20 years were randomly assigned to two forms of outpatient family therapy

(with [FTFM] and without [FT]) using the FMI, and treated for a 6-month duration. Their

outcome was compared at the end of treatment (EOT) and at a 6-month posttreatment fol-

low-up (FU). The main outcome measure was weight recovery; secondary outcome mea-

sures were the Morgan Russell Global Assessment Schedule (MRHAS), ameno rrhea,

general psychological symptoms, and eating disorder symptoms. The majority of the

patients in both groups improved significantly at EOT, and these changes were sustained

through FU. Given its primarily clinical nature, findings of this investigation project pre-

clude any conclusion. Although the FMI did not appear to convey specif ic benefits in caus-

ing weight gain, clinical observation suggests the value of a flexible stance in

implementation of the FMI for the severely undernourished patient with greater psy-

chopathology.

Keywords: Anorexia Nervosa ; Family Therapy; Family Meal; Exploratory Investigation;

Outpatient

Fam Proc 56:364–375, 2017

INTRODUCTION

Eating disorders have become a major health problem in most western countries with

large numbers of adolescent girls practicing abnormal eating behaviors and suffering

from clinical eating disorders. Because anorexia nervosa is commonly ego-syntonic, sel-

dom does the patient seek treatment. She/he is usually referred for therapy, and ada-

mantly opposes weight restoration. In fact, the main psychopathology in AN is related to

the feared consequences of food intake, and clinicians are well aware of the danger

involved in focusing on the expressed intent to avoid food rather than on the potentially

*Committee on Nutrition, Health and Quality of Life, International Life Sciences Institute (ILSI Argentina),

Buenos Aires, Argentina.

†

Faculty of Health, Deakin University, Burwood, Vic., Australia.

Correspondence concerning this article should be addressed to Cecile Rausch Herscovici, Committee on

Nutrition, Health and Quality of Life, International Life Sciences Institute (ILSI Argentina), Av. Santa Fe

1145, Buenos Aires C1509 ABF, Argentina. E-mail: cecilerh@ilsi.org.ar

The main author wishes to express her deep gratitude to Professor Gerald F.M. Russell, M.D. F.R.C.

Psych., for his most valuable suggestions to the earlier version of this manuscript.

364

Family Process, Vol. 56, No. 2, 2017 ©2015 Family Process Institute

doi: 10.1111/famp.12199