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Anorexia and the Body of Christ

Sep 10 2010
Harriet Brown's success story using family based treatment for her daughter's eating disorder suggests we 'all' could stand to share meals.

Harriet Brown's new memoir, Brave Girl Eating: A Family's Struggle with Anorexia, challenges popular beliefs about eating disorders. Many psychologists and nutritionists say that getting anorexics to eat won't work until "underlying psychological issues" are dealt with, yet many anorexics die before that can happen. The deadliest of all psychological disorders, anorexia has an abysmal recovery rate: 30 to 40 percent recover completely; 20 percent die; the rest cycle in and out of hospitals and treatment programs.

When Brown's 14-year-old daughter, Kitty, became anorexic, the author voraciously read up on the disorder. Dissatisfied with traditional explanations and terrified by the recovery rates, she encountered a lesser-known option: Family Based Treatment (FBT), or the Maudsley Approach. It sounds simple enough: Phase 1: Restore the patient's weight. Phase 2: Return control over eating to the patient. Phase 3: Resume normal development. It's done at home, with Mom and Dad sitting with the anorexic child at every meal, packing them with the calories needed for recovery.

Absurdly simple, or simply absurd? Amazingly, patients treated with FBT have close to a 90 percent recovery rate, more than twice the rate of patients treated with traditional methods. FBT seems so revolutionary because it has been assumed that no one—least of all, parents—should make anorexics eat. It's wonderfully sensible that in FBT, parents (guided by professional therapists and doctors) manage their children's care. Brown is careful to note that she and her family have their faults, but she comes across as a dedicated mother, one who admits that sending Kitty to a residential treatment facility would be in some ways easier, but who nonetheless, with her husband, faces down the "demon" of anorexia (as she calls it). She gives many reasons for why her family chose this path; perhaps the most persuasive is this:

We have something no one else in the world has: we love Kitty best. No one else in the world can possibly want her to get better as much as we do. No one else loves her as fiercely, as nonjudgmentally, as unconditionally as we do.

Love, I suspect, is the active ingredient in FBT. The first act of love from parent to child involves feeding, by breast or bottle. Indeed, many of the things Kitty does when working through FBT mimic babyhood. She eats with baby utensils, sleeps on her parents' bedroom floor, goes with them to work, is supervised at every meal and snack (spending five hours a day at table), and cries herself to sleep in their arms. She gains weight. Slowly, she returns from near-death.

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