September 17, 2010

Insight and eating disorders: overrated?

I really think this is the best mainstream article on the Family-Based Maudsley approach to date:

Eating-Disorder Treatment: A Family Affair

It includes a quote from Daniel le Grange that will upset and challenge the majority of eating disorder clinicians - and it is time for them to face and discuss it: "There's no evidence that understanding what causes an eating disorder helps the adolescent recover"

We need to be discussing this. If this is true, then most of the treatment out there for ALL patients needs to be re-thought. It seems so logical that patients need to understand in order to move forward toward recovery. I don't think they do - I think that is our job UNTIL THEY CAN. And if full nutritional restoration for months at a time is necessary to get there, then that needs to be our goal as family, friends, clinicians, and society.

Insight is, in my opinion, a sign of recovery - not a requirement to access care. Let's stop asking patients to understand and change; we need to change how we respond.

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