Treating Bulimia in Adolescents

Daniel Le Grange, PhD, is Benioff UCSF Professor in Children’s Health in the Department of Psychiatry and Behavioral Sciences and UCSF Weill Institute for Neurosciences and Director of the Eating Disorders Program at the University of California, San Francisco. He is Emeritus Professor at the University of Chicago, where he was Director of the Eating Disorders Program until 2014. Dr. Le Grange trained at the Institute of Psychiatry, Psychology and Neurology, University of London, and was a member of the team at the Maudsley Hospital in London that developed family-based treatment for anorexia nervosa. Over his career, he has treated numerous adolescents and families struggling with eating disorders. He is a recipient of the Leadership Award in Research from the Academy of Eating Disorders and an Early Career Development Award from the National Institute of Mental Health, and is a Fellow of the Academy of Eating Disorders.James Lock, MD, PhD, is Professor of Child Psychiatry and Pediatrics in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. He is also Director of the Stanford Child and Adolescent Eating Disorders Program. The author of numerous scientific publications on eating disorders in youth, Dr. Lock is a Distinguished Fellow of the American Psychiatric Association and of the American Academy of Child and Adolescent Psychiatry. He is a recipient of awards including the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association, the Price Family Foundation Award for Research Excellence from the National Eating Disorder Association, the Leadership Award in Research from the Academy of Eating Disorders, and Early and Mid-Career Development Awards from the National Institute of Mental Health.

"When treating adolescents with bulimia nervosa, clinicians owe it to their patients to consider how family involvement might benefit treatment. This welcome book is authored by two of our most esteemed authorities on family-based intervention for eating disorders. Grounded in extensive research and practice, the manual offers theoretical perspectives, a clear rationale for the treatment, and practical instruction on implementing the techniques. The evidence-based approach and excellent clinical illustrations provided by Le Grange and Lock will enrich the therapeutic armamentarium of novices and experienced clinicians alike."--Joel Yager, MD, Department of Psychiatry and Biobehavioral Sciences, University of New Mexico School of Medicine; past president, Academy for Eating Disorders "The family-based approach has offered patients a genuine paradigm shift in the treatment of eating disorders, and real hope for recovery from a complex illness. Le Grange and Lock build here on their authoritative manual for the treatment of adolescent anorexia to deliver the first such manual for adolescent bulimia. This book is essential reading for those who seek empirically based, therapeutically sound treatments for children and adolescents with eating disorders."--Leslie A. Sim, PhD, Department of Psychology and Psychiatry, Mayo Clinic "Le Grange and Lock have written an eminently practical guide. Their approach emphasizes a positive view of parents, as agents in reestablishing healthy eating for adolescents with bulimia nervosa; of the family, as a resource for recovery; and of adolescents themselves, as competent and autonomous--except in relation to their disordered eating. Detailed case studies show how the therapist can model uncritical acceptance of the patient and separate the illness from the individual. This book belongs in the library of any professional who treats eating disorders."--Richard E. Kreipe, MD, Department of Pediatrics, University of Rochester Medical Center "This is a seminal resource for both researchers and clinicians. Not only will this book assist in understanding the dynamics and treatment for families with a child with bulimia nervosa, but the comparisons presented with families with a child with anorexia nervosa also help to solidify understanding of those dynamics as well. A very thoughtful and thorough presentation."--Nancy Zucker, PhD, Duke Eating Disorder Program, Duke University Medical Center "Written by two specialists on eating disorders, this book provides a detailed description of a family-based treatment for adolescents with bulimia nervosa. Practical in orientation and comprehensive in scope, this is an invaluable resource for clinicians."--Christopher G. Fairburn, OBE, DM, FRCPsych, FMedSci, Department of Psychiatry, Warneford Hospital, University of Oxford, United Kingdom "A welcome companion to the Treatment Manual for Anorexia Nervosa, this practical guide to treating bulimia nervosa in young people provides step-by-step guidance for clinicians experienced in working with young people and their families. Written by leaders in the field, the manual brings transparency of process and purpose to the treatment of what can be complex clinical problems. The authors' personal experience translating theory into practice and dealing with the real issues encountered in therapy is evident throughout. I would recommend this book to anyone new to working with young people with eating disorders."--Dasha Nicholls, MD, PhD, Head, Feeding and Eating Disorders Service, Great Ormond Street Hospital and the Institute of Child Health, London, UK - A theoretical, yet easy-to-follow manual combining case studies with theory and examples of the practice approach. Highly practical, the book shows evidence-based strategies for practitioners to best support adolescent sufferers of bulimia, while helping the family develop skills to cope with the complexities of the illness and to work collaboratively to bring the eating behaviours under control....This is an extremely useful tool for therapists working with adolescents and their families. --Addiction Today, 6/21/2009Æ’Æ’ Most therapy manuals suffer from one of two excesses. They are either overly theoretical, and hence very dreary to read, or they are little more than a series of case examples or anecdotes, providing entertaining reading but inadequate instruction. Treating Bulimia solves these problems in a simple and effective manner. It presents a chapter outlining the theory and practice of the approach, followed by the same material in Action, in which an extended case example illustrates the material presented in the previous chapter. No matter what one's learning style, at least one of the elements of Treating Bulimia will resonate with the reader. For those who like to know the rationale behind techniques, the theory chapters explicitly tell us how to carry out the session...followed by why....Treating Bulimia is most useful for the practicing therapist who works with adolescents and their families and wants to improve his or her skills in treating bulimia. --Bulletin of the Menninger Clinic, 6/21/2009

• 1. Introduction and Background Information on Bulimia Nervosa2. Family-Based Treatment for Adolescent Bulimia Nervosa3. Phase I: Initial Evaluation 4. Session 1: The First Face-to-Face Meeting with the Family5. Session 1 in Action6. Session 2: The Family Meal 7. Session 2 in Action8. The Remainder of Phase I (Sessions 3–10) 9. The Remainder of Phase I in Action 10. Phase II: Helping the Adolescent Eat on Her Own (Sessions 11–16) 11. Phase II in Action 12. Phase III: Adolescent Developmental Concerns (Sessions 17–20) 13. Phase III in Action 14. Summary of a Completed Case