Eating Disorders and Teens

Treatment Trends

What Are Eating Disorders?

According to the Diagnostic and Statistical Manual of Mental Disorders (2013), eating disorders are generally described as significantly altered eating behaviors that have an enormous negative effect on physical health, behavior, and thought processing .

There are 6 disorders under this category:
  • Anorexia Nervosa
  • Avoidant/Restrictive Food Intake Disorder
  • Binge-Eating Disorder
  • Bulimia Nervosa
  • Pica
  • Rumination Disorder

Treatment Goals for Eating Disorders

There a few things the must be included any treatment plan for any adolescent who has an eating disorder. Firstly, there should be a multidisciplinary team to assist in treatment that includes a physician, dietician, and mental health professional. Additionally, there are four areas that must be addressed in treatment:

  1. Medical - weight improvement to a healthy BMI and improved physical health
  2. Nutritional - return to normal eating that fulfills nutritional requirement for developmental stage.
  3. Psychological - return to cognitive thinking and self-image that is not distorted and is more realistic
  4. Family - address family relationships and conflicts that can contribute to the presence of the disorder.

(Rosen, 2010)

Treatment Options

There are a variety of treatment options for eating disorders that can be placed under 5 different areas (Rosen, 2010):
  1. Collaborative Outpatient Care
  2. Family-Based Therapy
  3. Day-Treatment Programs
  4. Hospital-Based Treatment
  5. Pharmacotherapy

The current trends in ED treatment are:
  • Mindful-Based Cognitive Therapy (MBCT)
  • Dialectical Behavior Therapy (DBT)
  • Mindfulness Eating Awareness Training
  • Art Therapy

Mindful-Based Cognitive Therapy (MBCT)

MBCT stems from Cognitive-Behavioral Therapy (CBT) which is based on the idea that the way we perceive events, determines how we feel about them, which influences how we behave. CBT works to replace negative and maladaptive thoughts with positive ones to eventually change the negative behaviors. MBCT combines these principles with self-control and self-improvement, found in early Buddhism.

MBCT helps:

  • the depression component of eating disorders (mindfulness has been seen to help with depression more recently)
  • eliminate the need to binge and purge by making client more self-aware of behavior
  • maladaptive dieting and distorted body image

Dialectical Behavior Therapy (DBT)

DBT can be used in clients who over eat. When using DBT in clients with eating disorders, practitioners focus on awareness, emotional regulation, and pain tolerance. The behavior of eating temporarily relieves negative feelings and is thus a learned pattern to make oneself feel better.

DBT helps:

  • address overeating habits and relieve negative emotions
  • counteract emotional band-aid that food gives binge eaters
  • promotes adaptive choices by recognizing present moment without taking part in impulsive conduct
  • remove self from controlling and berating feelings
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Mindful-Based Eating Awareness Training

MB-EAT many times is simultaneously used with Mindful Based Stress Reduction and CBT techniques, in addition to meditations to help self regulate eating habits. This practice addresses individual's shape, weight, and the eating process as a whole. Ultimately, MB-EAT aims to maintain behavioral changes that replaced emotional eating through nonjudgmental awareness of thoughts and feelings.

MB-EAT helps:

  • control cravings and binge eating patterns
  • utilize traditional and guided meditations
  • increase awareness of instinctive behaviors
  • withdrawal from unwanted pattern

Art Therapy

Art Therapy can be particularly helpful in treating eating disorders because many people struggling with eating disorders have a difficult time verbalizing their feelings. Art therapy provides a creative outlet for the pain and experiences that may be too overwhelming to express in words. Art therapy is a way to allow a client to experience their emotions while also gain confidence in their ability to cope.

One technique used in art therapy is called body tracing. Body tracing is when a client draws what they believe their body shape looks like on a large piece of paper. After discussing this image, the therapist traces the clients actual body on the paper and discuss the differences and the internal beliefs that the client has about their body. The therapist challenges these ideas with the reality of their bodies shown on the paper.

Another form of art therapy used is narrative expressions, such as an altered book. In an altered book, clients are asked to take an already existing book and tweak the components to match their experiences and realities. This book serves as a tool for self-reflection of their recovery process and their mental state throughout.

Traditional forms of art such as painting, drawing and sculpting are also used to help the client creatively express their treatment process. A collection of this work is kept as a part of the clients record and is often given to the client as they make their transition out of inpatient treatment. This body of work serves as a reminder of their progress for themselves and their outpatient therapists.

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  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  • Baer, R., Kristeller, J. & Quillian-Weaver, R. (2006). Mindfulness based approaches to eating disorders. Mindfulness-based treatment approaches: Clinician's guide to evidence base and applications. Amsterdam: Elsevier, Academic Press.
  • Expressive Theapy. (2015). Retrieved May 15, 2016, from

  • Slyter, M. (2012). Treating eating disorders with the Buddhist tradition of mindfulness. Ideas and Research You Can Use: VISTAS. 1.
  • Rosen, D. (2010) Identifying and treating eating disorders. American Academy of Pediatrics.