In the context of Family-Based Treatment (FBT) for Anorexia, the primary goal of medical nutrition therapy is to utilize a comprehensive approach that integrates the active participation of the family in fostering complete recovery and holistic well-being. This specialized therapy focuses on restoring and stabilizing nutritional health, with certified medical nutrition therapy dietitians guiding families in planning, preparing, and overseeing meals to ensure gradual and monitored weight restoration.

Medical nutrition therapy within the FBT framework empowers families to actively contribute to modifying disordered eating behaviors, rebuilding trust, and promoting open communication within the family unit. It addresses psychological factors associated with Anorexia, collaborating with mental health professionals as needed. Throughout the process, the therapy supports the transition of responsibilities back to the individual, fostering a sense of autonomy and independence. Ultimately, the goal is to improve overall well-being, encompassing physical and mental health, and to guide individuals towards embracing life with vitality and renewed wellness through the principles of medical nutrition therapy within the collaborative framework of FBT.

Family Based Treatment (FBT) is an evidence based treatment for children and adolescents with anorexia. It uses the family and caregivers to help their child recover from their anorexia.

With locations in Colorado Springs and Fort Collins, Colorado, as well as Woodinville, Washington, our services extend to patients across the state and country through in-person and online nutrition counseling.

What are the five principles of FBT?

1. The nutrition therapist holds an agnostic view of the eating disorder.

2. Anorexia is separated from the patient and externalized.

3. This is a non-authoritarian treatment.

4. Parents are empowered. The goal is to empower parents or caregivers to nourish their child and help their child achieve recovery. As parents, you know your child best. As dietitian nutritionists and healthcare providers, we are here for guidance and support.

5. Focus on treating the eating disorder vs finding a cause. The focus is pragmatic. The focus is now and how, now why. There is also no blaming of the parents or caregivers.

What does nutrition therapy for anorexia using Family-Based Treatment (FBT) look like?

What are the stages of the FBT process?

There are 3 Phases of FBT.

• PHASE 1: Parental management and weight restoration.

• In phase 1, parents or caregivers are in charge of planning, prepping, and plating all meals and snacks to help their child get adequate nutrition. If weight restoration is needed, this is also an essential goal, as full weight restoration is an important part of recovery.

• PHASE 2: Gradual return of control to your child or teen.

• As the eating disorder behaviors subside and weight is restored, the adolescent can help to choose or prep some meals or snacks.

• PHASE 3: Establishing healthy independence.

• This may be where treatment shifts from a family-focused treatment towards helping the adolescent develop an identity and independence while also being free of their eating disorder.

What is the length of treatment for Family Based Treatment?

FBT and anorexia recovery is a marathon, not a sprint. It often takes several months or longer to restore adequate nutrition and weight. It also can take up to a year after that for eating disorder thoughts to decrease or disappear. 

Sometimes, more intensive treatment options may be recommended. This does not mean your child or family is failing at FBT or outpatient treatment. Often, the eating disorder is so strong, or there are medical consequences, that a higher level of care would be beneficial before returning to outpatient treatment.

Since treatment can be intensive, it’s so important to engage in self-care as the parent or caregiver. This can mean using family or friends for support, eating disorder support groups for caregivers, or alternating who eats meals/snacks with your child.

Typically, it’s recommended to meet with your dietitian and FBT therapist weekly, but this can be individualized to your family’s situation.

What puts children at risk for Anorexia?

Eating disorders may arise from a blend of genetic, biological, psychological, and environmental influences. While they can impact people of all ages, including children, particular elements may elevate the likelihood of eating disorder development in this demographic. It's noteworthy that these risk factors don't automatically lead to the onset of an eating disorder, and various elements could play into an individual's susceptibility. Here are several potential risk factors for eating disorders in children:

• Genetic Factors: Evidence suggests a genetic predisposition to eating disorders, meaning children with a family history of eating disorders or other mental health conditions might face a higher risk.

• Psychological Factors: Certain personality traits like perfectionism, low self-esteem, or self-criticism may render children more susceptible to eating disorders.

• Sociocultural Influences: Societal pressures, idealized body images in media, and cultural emphasis on thinness can foster body dissatisfaction and impact the development of eating disorders.

• Peer Influence: Children influenced by peer pressure to conform to specific body standards or engage in unhealthy eating behaviors may be at increased risk.

• Dieting and Weight Concerns: Children practicing dieting or expressing worries about weight and body shape may be prone to developing disordered eating patterns.

• Sports and Activities: Participation in sports or activities focusing on weight, body shape, or performance, such as gymnastics or wrestling, may heighten the risk of eating disorders in children.

• Childhood Trauma: Exposure to traumatic events, such as abuse, may contribute to eating disorder development in some children.

• Parental and Family Influence: Family dynamics, parental attitudes toward body image and weight, and modeling of unhealthy eating behaviors can shape a child's view of food and body image.

• Mental Health Conditions: Children with pre-existing mental health conditions like anxiety or depression may face an increased risk of developing eating disorders.

• Puberty and Body Changes: The physical and hormonal changes during puberty can lead to body dissatisfaction and elevate susceptibility to eating disorders.

 What does a dietitian do for ED?

Our devoted team of nutrition experts specializing in eating disorders is dedicated to guiding clients toward a journey of healing that transcends fear and shame. By addressing concerns around food and dismantling negative body image perceptions and behaviors, we empower clients to reclaim ownership of their relationships with food and body and to shift their outlook, beliefs, and behaviors towards love, respect, and acceptance. This transformation paves the way for sustainable recovery and lasting wellbeing. Together, we strive to eradicate feelings of shame related to food and body image, identify triggers that fuel self-doubt, and nurture a trusting relationship with both food and body, creating space for our authentic selves and true values to emerge and thrive.

Recognizing that each individual holds the key to their own healing journey, our diverse team of medical nutrition specialists facilitates a process of self-exploration and empowerment. Recovery from an eating disorder and disorder eating extends beyond overcoming the eating disorder; it involves cultivating a rich and empowered life through healing around food and body image.

A full treatment team is recommended in order to provide effective care. Your dietitian at Side by Side can help refer you to other care providers.

• A dietitian can assist in developing and adjusting a suitable meal plan, offer educational resources, facilitate exposure to diverse foods to broaden variety, provide exercise recommendations, help with body image struggles, aid in challenging eating disorder thought patterns and much more.

• A FBT family therapist who has been trained specifically in FBT can with the family to provide support for challenges, help teach coping skills, provide guidance, and more.

• A PCP that is ideally educated on eating disorder can help regularly monitor vital signs, weight, labs, and any other tests recommended.

• Other providers, such as a psychiatrist or therapists for other family members, may be recommended.

What does nutrition therapy include?

TESTIMONIALS

Our team of Expert Dietitian Nutritionists Have Been Featured In:

Our Team of Dietitian Nutritionists, Expert ED and Medical Nutrition Counselors

The Side by Side Nutrition team has a team of 12+ outpatient registered dietitians. We provide online nutrition counseling to patients in Colorado and around the country. We offer one-on-one and family nutrition counseling for patients either online or in person, with offices located in Colorado Springs and Fort Collins. We specialize in eating disorder recovery and body image healing.

RD - Registered Dietitian
RDN - Registered Dietitian Nutritionist
MS - Masters of Science

As specialists in ED nutrition counseling our mission is rooted in compassion. We:  

• Strive to create a safe and nurturing space for individuals on their journey to wellness. 

• Understand the profound impact that eating disorders can have on one's life.

• Are committed to fostering a supportive community where every client feels seen, heard, and understood. 

• Work from an intuitive eating, HAES (Health at Every Size) Informed Approach.

• Believe everyone has the right to high-quality care – accessibility and inclusivity are at the core of our values.

• Stand firm in our belief in the possibility of full recovery. 

• Continually invest in our education to stay at the forefront of the field.

• Are committed to ongoing learning.

• Channel all our resources into becoming the best eating disorder nutritionist counselors.

• Are dedicated to guiding our clients toward a life of lasting health and empowerment.

We Accept Insurance:

We are committed to ensuring that our clients have access to healthcare, and we make every effort to facilitate this. We accept insurance plans such as BlueCross Blue Shield (Anthem/Regence), United HealthCare (Optum), Aetna, and Cigna.

Dietitian for ED and Medical Nutrition Therapy FAQ

How successful is FBT?

FBT has shown success in the treatment of anorexia nervosa, particularly in adolescents. Research indicates positive outcomes, including weight restoration and improved family dynamics. Success may vary among individuals.

How does the success of Family-Based Treatment (FBT) compare to individuals attempting to manage anorexia nervosa independently in adolescents?

Family-Based Treatment (FBT) has demonstrated greater success in treating anorexia nervosa in adolescents compared to individuals managing it independently. The active involvement of the family in FBT contributes to more positive outcomes, including weight restoration and improved psychological well-being.

What are the cons of FBT?

While FBT has demonstrated effectiveness, it may not be suitable for everyone. Some cons include the intensive involvement of the family, potential resistance from the individual, and the need for specialized and experienced providers who may not be as accessible.

What common family dynamics are associated with anorexia nervosa?

Common family dynamics associated with anorexia nervosa may include high levels of control, perfectionism, communication difficulties, enmeshment, and challenges in expressing emotions.

Is family-based treatment evidence-based?

Yes, family-based treatment (FBT) is considered evidence-based for the treatment of anorexia nervosa, especially in adolescents. Research supports its efficacy in promoting weight restoration and recovery.

What is family-based treatment for eating disorders?

Family-Based Treatment (FBT) for eating disorders involves collaborative efforts between the individual, their family, and treatment professionals. It aims to address maladaptive eating behaviors and improve family dynamics.

What is Maudsley Family-Based Treatment?

Maudsley Family-Based Treatment (FBT) is a specific form of family therapy for anorexia nervosa. It originated from the Maudsley Hospital in London and emphasizes family involvement in the refeeding and recovery process.

What insurance plans do you accept?

Side By Side Nutrition is in network with Cigna, Cigna Localplus, Aetna, BlueCross Blue Shield (Anthem/Regence), UMR, and United Healthcare. Prior to your visit, please call your insurance company to check your benefits. We can not guarantee coverage. For other insurance companies, we are out-of-network providers. This means we can provide you a superbill to submit to insurance for possible reimbursement. SBS can not submit superbills without a medical diagnosis. Payment is due at time of service for folxs using out of network benefits.

How does treatment work? What does a typical session look like?

An outpatient team consists of a dietitian, therapist, and primary care physician at minimum. Sessions are highly individualized and change from week to week depending on the needs, goals, behaviors, and journey of each client. Our dietitians are constantly assessing the needs, progress, safety, and next steps with their client’s short and long term goals in mind. 

An outpatient team works collaboratively to ensure clients get the best care for their recovery while staying in their day to day life. Clients in eating disorder recovery being treated on the outpatient level will typically visit with their dietitians 1-2x/week, therapist 1-2x/week, PCP monthly, and psychiatrist as needed.

I don’t live in Colorado, can we still work together?

Absolutely! We are passionate about making care accessible for you and offer telehealth services and online nutrition therapy when appropriate. We will meet via a HIPAA-compliant video conference platform and communicate between sessions using email. 

We provide nutrition counseling to clients from around the county. 

Do you work with children and adolescents?

Dietitians at Side By Side Nutrition work with teens and adolescents ages around 9+ and up. With treating adolescents for an eating disorder, we typically use a modified family based treatment approach which involves treating the entire family. You can learn more about Family Based Treatment for eating disorders here.

How do I get started?

You can schedule directly online here!

You can also contact us to help you schedule via our contact form here.

If you have any questions about working with us or scheduling, feel free to contact us via email or phone: contact@sidebysidenutrition.com or call us at 708-717-7394.