Stanford Medicine Newsletter Updates For the Local Community

Parents help treat eating disorders

Spring 2008

Play eases the anxiety of Bernard Dannenberg's young patient.

James Lock, MD, PhD, involves the family in the recovery process for eating disorders.

Most parents know what it feels like to want desperately to “fix” their child’s problem, be it a broken toy or a broken heart. But until recently, parents of children with eating disorders were shut out of their child’s recovery and perhaps even blamed for its development.

A new approach, known as family-based treatment, is gaining rapid acceptance across the country, thanks to Packard Children’s Hospital child psychiatrist and eating disorders specialist James Lock, MD, PhD. 

“We’ve gone from laying the blame for eating disorders at the feet of the parents to really seeing these conditions as diseases,” said Lock, who pioneered the treatment, also known as the Maudsley approach, in the United States in 2001. “We now know that it’s much more developmentally healthy to keep these kids in the community if possible and to involve their family in the recovery process.”

Lock estimates that he and his colleagues have trained more than 1,000 eating disorder specialists around the country to incorporate family-based therapy into their treatment protocols.

Packard Children’s Hospital couples the longest continuously running inpatient eating disorders program in the Bay Area with an evidence-based outpatient program staffed by adolescent specialists to meet each patient’s medical and psychiatric needs.

“We provide the most advanced, most effective treatments available,” said Lock. “We’re very family and developmentally oriented, and we’re uniquely able to understand and address the differences between what a 9- versus a 14- versus a 21-year-old patient will need. We offer a blame-free, solution-oriented approach.”

Family-based therapy is focused on quickly improving the child’s health and breaking the cycle of the disease, which becomes increasingly difficult to treat the longer it persists.

Because severely malnourished adolescents are unable to rationalize or understand their actions, they must be returned to a healthy weight before trying to explore the roots of their disorder.

“We’ve got to get a handle on how best to help these people,” said Lock. “It’s a huge dilemma. The societal cost of these disorders is staggering. And yet until recently very little research was done on treatment options. We are committed to helping these kids.”

In addition to maintaining a large-scale comparison of family-based and individually oriented treatment, Lock and his colleagues are involved in research comparing two types of therapy—one focused on symptoms and weight restoration, and one on family processes—and are investigating the effectiveness of a treatment called cognitive remediation therapy through a recently funded NIH study.

Other research projects are looking at brain imaging in eating disorder patients, the management of osteoporosis in anorexia nervosa, how adolescents utilize Internet sites that promote eating disorders and how differences in gender and ethnicity affect eating disorder symptoms.

For more information about this program, please call (650) 498-4468 or visit

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