Services

Eating disorders have one of the highest morbidities of any psychiatric illness, primarily due to the impact of malnutrition on multiple bodily systems. Medical monitoring during the recovery journey varies in intensity depending on the level of care. In general, most patients will have a robust initial work-up with periodic laboratory evaluations, vital sign assessments, weigh-ins, and physical exams to ensure medical stability. The frequency of each evaluation will depend on the patient's stability and stage of recovery.

The medical director will also address new symptoms or concerns (e.g., GI symptoms, dizziness, palpitations) as they arise and will provide medication or recommendations for medication. At any point, if a patient displays objective signs of medical instability, the treatment team will refer to Children's Memorial Hermann Hospital Emergency Center for evaluation and possible inpatient admission. Medical management plans will be made jointly with the parents and caregivers.

Family-based treatment is the gold-standard evidence-based treatment for adolescents with anorexia nervosa and bulimia nervosa. It shows strong promise for avoidant/restrictive food intake disorder and other eating concerns. In family-based treatment, caregivers play a central role in helping their child return to healthy eating.

Early on, families may share meals in a session with therapist support, learning how to ensure their child gets the nutrition they need — whether that means restoring weight, building variety, or reducing fears of food. Over time, responsibility for eating gradually returns to the adolescent. Treatment then shifts to supporting healthy independence and normal adolescent development.

Enhanced Cognitive Behavioral Therapy (CBT-E) is an evidence-based treatment for eating disorders that can be especially useful for older adolescents. While family-based treatment is the first-line approach for youth, CBT-E can help adolescents more actively address the thoughts and behaviors that maintain their eating disorder — such as rigid dietary rules, body-checking, or over-evaluation of weight and shape — while still supporting age-appropriate independence.

Cognitive Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR) normalizes eating, expands food variety, and supports healthy growth when needed. Using strategies based on exposure, CBT-AR addresses sensory sensitivities, low interest in food, or fears of negative consequences from eating (e.g., choking or vomiting). Treatment may be delivered with strong family involvement for younger patients or individually for older teens.

Exposure and Response Prevention (ERP) is the gold-standard treatment for anxiety disorders and obsessive-compulsive disorder, which often occur alongside eating disorders. In the context of eating disorders, exposure and response prevention supports exposures to feared foods, body-related concerns, and other anxiety triggers.

By gradually facing these challenges without relying on avoidance or compensatory behaviors, patients learn to reduce fear, build flexibility, and challenge unhelpful beliefs. Exposure and response prevention can enhance eating progress, increase anxiety tolerance, and support recovery across food, body, and co-occurring concerns.

In our program, Dialectical Behavioral Therapy (DBT) skills are integrated into eating disorder treatment to support emotional regulation, distress tolerance, mindfulness, and effective communication. These skills can be especially valuable for adolescents who struggle with binging, purging, or heightened emotional sensitivity. By integrating dialectical behavioral therapy into our care model, we give adolescents practical tools they can use both in recovery and in everyday life.

Nutrition counseling focuses on you or your child's unique dietary habits and challenges. A registered dietitian will work closely with you to help you understand and improve your relationship with food. This weight-inclusive and supportive process involves analyzing eating behaviors, exploring experiences with hunger, and understanding thoughts and body signals.

Through personalized recommendations, you will set achievable goals and develop coping skills for challenges. The focus may be on enhancing hunger and satiety awareness, mindful eating, improving flexibility and comfort when you eat, or reducing preoccupation and rigidity with food choices. Ultimately, this journey aims to build a healthier, more balanced relationship with food and health.

Using nutrition care informed by family-based treatment, you will:

• Understand the principles of family-based treatment: Discover how this method transforms treatment for children and adolescents.
• Increase confidence at home: Learn strategies to intervene on eating disorder behavior and provide compassionate support that leads to recovery.
• Overcome challenges: Navigate common obstacles in family-based treatment.