Breaking Barriers with Family-Based Treatment (FBT) for Anorexia Nervosa


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The role of family in the process of recovery from an eating disorder is vital to success. Among the variety of treatment options for eating disorders, family-based treatment (FBT) is one of the most promising and effective approaches to treating children and adolescents living with anorexia nervosa. By engaging in family therapy, caregivers gain valuable tools and skills to positively impact their one’s journey in recovery.

What Is Family-Based Treatment?

Family-based treatment is a therapeutic approach aimed at restoring normal eating patterns and nutrition with direct participation and support from families and caregivers. It is mainly used for adolescent and young adult individuals with eating disorders, such as anorexia nervosa or bulimia nervosa

FBT is based on the idea that family involvement is essential for successful recovery and that the family should actively participate in the treatment process. Unlike residential or partial hospitalization programs, FBT is less disruptive to daily life, allowing individuals to live at home and continue to attend school or work.

FBT typically involves three phases:

  • Phase 1: Focus on refeeding, weight restoration, and stabilization of physical health. Caregivers are responsible for providing and supervising every meal and snack and monitoring behaviors around food with the guidance of a treatment team consisting of clinicians, therapists, and dietitians.
  • Phase 2: Gradual transition of control and responsibility back to the individual suffering from the eating disorder, with continued monitoring by the family and support of the treatment team.
  • Phase 3: Maintenance of physical health and normal development while focusing on and addressing underlying causes of the eating disorder, such as depression or past trauma, with the therapist.1 

What Are the Barriers to Family-Based Treatment?

For many families and caregivers, the question of “Will FBT work for our family?” takes time to work out. Many families worry about supervising every meal and monitoring behaviors around the clock. They may also be concerned about the time commitment involved and how to react when their child won’t cooperate with treatment. These are all valid concerns, and it’s important for families to know their limitations. 

Families and caregivers must be able to dedicate a significant amount of time to treatment and may have to take a leave of absence from work. They must also fully commit to implementing all the treatment guidelines, even if their child is resistant. FBT is most appropriate and effective for families with the capacity and the relationship with their loved ones to carry out these treatment responsibilities.2

What Are the Benefits of Family-Based Treatment for Anorexia Nervosa?

Besides providing individuals the opportunity to receive treatment at home, family-based treatment for anorexia nervosa may help individuals to be more active and engaged in treatment. The initial phase of FBT primarily focuses on stabilizing physical health and addressing the symptoms of starvation commonly found with anorexia. Symptoms like weakness, sleep disturbance, brain fog, difficulty concentrating, and inflexible thinking interfere with the motivation and energy needed to participate in a treatment program. 

Once symptoms begin to improve, individuals have a clearer mind, more energy, and a greater ability to make sound decisions and practice healthier behaviors. This gives them a better chance at a meaningful, long-lasting recovery.3

Overall, FBT is a collaborative and empowering approach that recognizes the family’s role as a key source of support. If you or your loved one suffer from an eating disorder and would like to learn more about effective treatments, reach out to Selah House or call 866-324-8081 to speak to one of our supportive staff.


  1. Eating Disorders Victoria. (2014). Family based treatment (FBT).
  2. Rienecke, R. D. (2017). Family-based treatment of eating disorders in adolescents: Current insights. Adolescent Health, Medicine and Therapeutics, 8, 69-79.
  3. National Eating Disorders Association (NEDA). (n.d.). Parent toolkit. Retrieved October 8, 2023, from

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