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The Importance of Family & Friends in Bulimia Nervosa Treatment for Adolescents

Two to three out of every 100 American women suffer from bulimia nervosa, and its onset is appearing in females at younger ages than ever before, according to the National Eating Disorders Association. In fact, 86% of people suffering from eating disorders report its onset by age 20. Every one of those young women has people who love and care about her: Parents, siblings, friends, teammates, coaches, teachers, and many others. Each of these people is affected personally as their loved one progresses through bulimia nervosa recovery but also plays a crucial role in the success of their eating disorder treatment.
The support of family and close friends during treatment for bulimia nervosa is closely linked to its effectiveness, and this is especially true in the recovery of adolescents and young women. Clinical psychologist Dr. Douglas Bunnell, Ph.D., FAED, says, “Family involvement in the treatment of eating disorders is really now seen as central and essential.” The bulimia nervosa recovery program at Monte Nido takes a comprehensive family approach to treatment, providing education, support, and close communication with every member of the family during the entire process.

With the arrival of the holiday season, now is a wonderful time to take a close look at the importance of family and friends in the successful treatment and recovery of someone suffering from bulimia nervosa mental health issues. For those families who have a loved one in treatment for bulimia nervosa health risks, the holidays can be challenging, but it can also be a time of connecting over special memories and bonding experiences. To help navigate these difficult times, here is a comprehensive look at the critical role family, friends, and other loved ones play in the treatment and recovery of eating disorders.

The Importance of Education

Knowledge is indeed power, and this could not be truer than in a situation where someone has a loved one in treatment for an eating disorder. It’s easy and perfectly natural to feel overwhelmed, frustrated, scared, anxious, guilty, and a host of other emotions, especially when loved ones first learn about the eating disorder and begin to explore treatment options.

One of the most important things to understand is that bulimia nervosa does not develop overnight, and recovery won’t happen overnight either. Treatment will take time, patience, and dedication on both the part of the person suffering from bulimia nervosa and their support network. It’s also critical to avoid the trap of asking, “Why?” and taking the blame for a loved one entering eating disorder treatment. This is a difficult time and it’s an easy trap to fall into, but recognizing that it is no one’s fault is paramount. Eating disorders and bulimia nervosa, in particular, are complex diseases with numerous factors.

Knowing that, families and other people close to someone in treatment for bulimia nervosa should seek education as well as their support system, as these two things very much go hand in hand. The greater someone’s understanding of bulimia nervosa and eating disorders is in general, the better support they can offer to the person going through the treatment and recovery process. Further, prioritizing self-care such as getting enough rest and emotional support themselves will ensure that everyone close to the young woman in recovery is at their best to support her. Assistant Clinical Director Gillian Tanz, MSW, LCSW, at Monte Nido recommends speaking with friends or clergy members at church, seeing a therapist, or attending a local or virtual support group. She also recommends the following websites to become better educated on eating disorder treatment:

Monte Nido also offers a comprehensive resource library for families which includes reading, webinars, videos, and much more to aid in the education of getting a thorough understanding of bulimia nervosa and its treatment. 

A Comprehensive Approach at Monte Nido

Once those nearest and dearest to the adolescent going through bulimia nervosa recovery have gotten over their initial emotions and begin to understand the eating disorder more objectively, it’s time to focus on the treatment process. Monte Nido has treatment programs specifically for adolescents, a partial hospitalization (PHP) program and intensive outpatient programming (IOP). In both programs, Monte Nido’s unique approach combines adolescent-only and mixed-milieu treatment options, taking into careful consideration age appropriateness and the patients’ clinical or medical needs. 

Monte Nido’s day treatment program for adolescents places a special emphasis on developmental and clinical issues that affect them. Individual treatment sessions are held on an as-needed basis. Components of treatment at Monte Nido’s partial hospitalization care level include: 

  • Psychotherapy and clinical content groups: Consisting of a weekly individual therapy session, relationship groups, and adapted skills groups, these groups meet adolescent-specific developmental and social needs.
  • Nutrition sessions: Working in tandem with the outpatient team, a registered dietitian holds these weekly sessions to develop healthy eating attitudes and behaviors. 
  • Relationship Patterns: Helping families identify and manage the stages of emotions in reaction to their loved one’s eating disorder, including teaching more effective methods of communicating, has a significant positive impact on the recovery from bulimia nervosa.
  • Family programming: As deemed appropriate, weekly individual family sessions, as well as multi-family group sessions, are held. Families also receive weekly phone calls in which they are provided an update on their adolescent’s progress.  
  • Academic support: It is critical that academic needs are being met while an adolescent is in treatment for bulimia nervosa, so Monte Nido offers programming in the afternoons to accommodate morning class attendance. Monte Nido also works closely with schools to develop IEPs (Individualized Education Programs). 

Once an adolescent is ready to step down partial hospitalization care, Monte Nido offers intensive outpatient treatment. The same top-tier level of clinical support is continued, but full participation in school is allowed and some group sessions are replaced by more individual sessions.

It’s important to remember that bulimia nervosa treatment is not a quick fix and requires a considerable amount of patience and dedication. Monte Nido emphasizes parents and other loved ones as equal partners in the development, progression, and success of eating disorder treatment and families are in the loop every step of the way. With that in mind, it is also important to recognize that no matter what efforts are made on the part of the support network, it is ultimately up to the young lady in treatment to want to recover fully and successfully, and to put in the work to do so.

How to Help

With a greater understanding of the type of bulimia nervosa treatment Monte Nido provides, it’s vital to understand how to help the recovering adolescent as their family and other loved ones, as well as how not to. An important consideration to bear in mind is that eating disorders, particularly bulimia nervosa, are complex diseases with many, many factors and it is perfectly all right to not have all the answers. Here are some helpful tips to help someone who is in treatment for bulimia nervosa health risks.

  • DON’T take it personally. It is extremely common for parents or close friends to blame themselves for their loved one’s illness, but there is nothing someone else could have done to prevent it. Other people simply do not cause eating disorders. Focus instead on getting effective treatment. 
  • DO communicate. Communication is key in so many ways when it comes to eating disorders. It’s critical to communicate honestly and openly — but gently — with the person suffering from bulimia nervosa, with treatment providers, and with other sources of support, such as a spouse or local resource group. On the other end of the spectrum, listen patiently and without judgment when the adolescent is speaking about their illness or when learning about it from a treatment provider.
  • DON’T do it alone. Finding one’s support network when helping someone in treatment for an eating disorder is crucial. This can include other family members, a therapist, or a group specifically for families of adolescents in bulimia nervosa recovery. Hearing from people whose family members have successfully recovered can be especially helpful and encouraging. Numerous reputable local groups meet in person, websites including F.E.A.S.T. (Families Empowered and Supporting Treatment of Eating Disorders), and social media groups. Monte Nido also offers a parent education program. 
  • DO remain objective yet caring. Be sure to use encouraging words when progress is being made in the treatment process, but express love and encouragement in general as well, not just concerning the eating disorder or body image.  
  • DON’T give up. Recovery and treatment from bulimia nervosa is a long, tiring road, and at times families may feel discouraged. Monte Nido’s Gillian Tanz, MSW, LCSW  says, “Our philosophy at Monte Nido is that real, sustained and permanent recovery from an eating disorder is possible. The road to being fully recovered is not easy, but the presence of loving supporters is essential to progress on that journey.”
  • DO care for yourself. Care and support for others simply are not possible if a person’s own needs are not being met. It’s essential to get a good amount of rest and taking care of one’s health and continue enjoying things just as before the onset of the eating disorder. Do not skip out on regular activities or things that can bring respite or joy.  

Special Consideration for Siblings

When an adolescent enters into treatment for an eating disorder, the entire family is affected and parents have to focus almost entirely on that child. There are numerous appointments, the child suffering from bulimia nervosa may not be in the home for some time, and the parents are consumed by anxiety. These things often cause other children in the home to become unintended victims, and it’s common for them to become jealous and develop their behavioral issues. Professional family counseling is highly effective in the successful treatment and recovery of eating disorders for the entire family, but particularly in instances where there are other children.

Monte Nido’s Family-Centered Program

Monte Nido provides specialized care for adolescents and maintains close communication with the entire family through every step of the treatment program, from day one to reintegration into the family after successful treatment. Families have healing to do themselves when a loved one undergoes treatment for an eating disorder, and Monte Nido recognizes this. All family members are encouraged to be active participants in the treatment journey and will be consulted on and communicated regularly. Multiple components where family members are actively involved are what makes Monte Nido’s program effective specifically for the treatment of adolescents suffering from bulimia nervosa. Some of the ways Monte Nido works closely with families include:

  • Weekly family therapy sessions, including remote or video conferences if family members are not local
  • Family meals, both supported and unsupported by Monte Nido staff
  • Off-site passes and overnight excursions
  • Monthly family weekend programming that includes group sessions, educational components, and shared meals
  • Weekly setting of individual family and relationship goals

Monte Nido provides comprehensive clinical and psychiatric care for adolescents suffering from bulimia nervosa or other eating disorders through a compassionate and collaborative approach, as well as all-inclusive academic and family support. To see if this treatment program is appropriate, contact Monte Nido today. 


Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.