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The role of family meals in the treatment of eating disorders: a scoping review of the literature and implications

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Abstract

Family meal research is a fast growing field that has significant implications for the prevention and treatment of eating disorders (ED). Using a scoping review procedure, this article overviewed major historical and clinical trends that have guided the use of family meals or lunch sessions in adolescent ED family therapy over the past 40 years, and synthesized essential findings from current therapeutic family meal research. The relevant body of literature is reported within the framework of three models of family therapy (Maudsley model, family-based treatment, multi-family therapy), with a focus on their specific use of family lunch sessions and related empirical evidence. Although promising, current evidence remains contradictory, tentative and colored by therapists’ convictions, resistance and fears. Future research priorities are discussed, including the need for a more direct examination of the impact of the family meal practice on therapeutic change, as well as a better understanding of its active ingredients and of the characteristics of patients/families that may benefit most from it. This review of the literature may help clinicians and family therapists (1) adhere more reliably and confidently to ED-focused treatment protocols that include a strong family meal component, and (2) make more informed decisions regarding the inclusion or exclusion of family meals in their practice. When feasibility or acceptability issues preclude their use, alternatives to family meals are also discussed, including family meal role-plays and drawings, coaching of home-based family meals and manual/DVD-based guidance.

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Notes

  1. “Mini-meal challenges” are used as part of an outpatient assessment of very ill patients, in order to determine whether outpatient treatment is indeed possible.

  2. A form of family therapy where support and guidance are provided to the patient and the parents in separate sessions by the same therapist.

  3. ED-focused family therapy (FBT) focuses on the facilitation of weight gain and more generally on resolving ED-related symptoms. In contrast, SFT focuses on the family system and addresses general family processes and relationships.

  4. MFT refers here to a therapeutic setting that includes 5–7 families simultaneously, all with a young person suffering from AN, and a therapeutic team. Ten MFT days are offered over a course of 9–12 months, with an initial “burst” of 4 consecutive days. The MFT program is supported by a treatment manual [48]. A more recent adaptation was developed for BN patients [49].

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  1. Department of Child and Adolescent Psychiatry, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019, Paris, France

    Solange Cook-Darzens

  2. 10 Grande Rue, 60460, Blaincourt, France

    Solange Cook-Darzens

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Cook-Darzens, S. The role of family meals in the treatment of eating disorders: a scoping review of the literature and implications. Eat Weight Disord 21, 383–393 (2016). https://doi.org/10.1007/s40519-016-0263-y

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