Outpatient

The UCSF Eating Disorders Program provides comprehensive outpatient services for the assessment, treatment, and follow-up of adolescents with eating disorders. 

 

EATING DISORDERS ASSESSMENT

Assessments are needed in order to make proper diagnoses and recommendations for treatment. The UCSF Eating Disorders Program has an extensive assessment process to ensure that the program is a good fit for you/your child’s treatment needs. The initial assessment procedure incorporates a combination of self-report questionnaires and interviews for the patient and caregivers that ask about eating disorder symptoms, as well as other psychiatric concerns

 

TREATMENT FOR EATING DISORDERS

Most individuals are seen for a course of outpatient treatment. In general, our program follows manualized treatment approaches backed by extensive clinical and research support. Because eating disorders usually have serious medical consequences, our program will also facilitate appropriate medical management through UCSF.

Adolescents are typically treated using manualized Family-Based Treatment, in which specific goals are set at the outset of treatment and reviewed throughout therapy. Treatment aims to address eating disorder issues in 20-25 sessions that are scheduled over 10-12 months. 

Treatment for eating disorders requires a multidisciplinary approach. Most treatments involve a combination of psychotherapy, psychoeducation, medical management, and nutritional counseling. Our program offers various types of therapy, which are selected according to the treatment that is most indicated for the particular disorder and the particular individual. There are several outpatient treatments that have been shown to be effective in the treatment of eating disorders.

1. Family Therapy

There are different types of family treatments. 

  • Traditional family therapies: therapies such as Structural Family Therapy focus on roles, alliances, conflicts, or interactional patterns within the family that are related to the eating disorder.
  • Family-based treatments: typically shorter than traditional family therapy (20 sessions) and instead of focusing on family dynamics, the initial focus is on putting parents temporarily in charge of helping to reduce control that the eating disorder has over their child's life. The first stage of treatment focuses on weight restoration and reduction of eating disorders symptoms.  Once the eating disorder is under control, parents return control over eating back to their child and help him/her with normal developmental tasks.

 

2. Cognitive-Behavioral Approaches

  • Cognitive Behavior Therapy (CBT) is the treatment of choice for adults with bulimia nervosa whose symptoms are moderate to severe. 
  • CBT is also recommended for adults with anorexia nervosa.
  • The therapy aims at correcting errors in thinking and perception that lead to negative self-perceptions and eating disorder symptoms. It is aimed at normalizing eating behavior and reducing restrictive eating by re-introducing ‘taboo' foods into diets and planning meals. The therapy involves self-monitoring of food intake, bingeing and purging episodes, and thoughts and feelings that trigger these episodes. CBT also involves regular weighing.
  • CBT for bulimia nervosa is short term (20 sessions) and for anorexia nervosa the length of treatment is longer.
  • Individual and/or group therapy formats exist for CBT.
  • Research has continually demonstrated the effectiveness of CBT for bulimia nervosa.  It is more effective than medication alone, supportive psychotherapy, behavior therapy, and is comparable to Interpersonal Psychotherapy (IPT; for a review see Wilson et al., 1997).
  • Research also suggests that CBT is effective for anorexia nervosa and binge-eating disorder (Garner & Needleman, 1997). 

 

3. Other Treatments

For certain individuals, other treatments may be appropriate. Such treatments include adolescent focused therapy for anorexia nervosa, supportive psychotherapy, and dialectical behavior therapy.