Guideline SupportedFamily therapyEating disordersSpecialist

Family-Based Treatment for Eating Disorders(FBT)

Last evidence review: January 20269 printable resources

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Overview

Family-Based Treatment (FBT), often called the Maudsley approach, is a structured therapy for children and adolescents with anorexia nervosa and related eating disorders. It empowers parents to take an active role in restoring nutrition and interrupting eating-disorder behaviours, then gradually returns control to the young person as recovery stabilises.

What this therapy focuses on

Rapid medical and nutritional stabilisation first, followed by a staged return of autonomy, with family support to reduce relapse risk.

What sessions are usually like

Session length: 60–90 minutes

Frequency: Weekly early, then tapering

Time-limited: Yes (typically 15–25 sessions)

Between-session work: Family meal support plans, monitoring, relapse prevention

Session profile

Duration: 60–90 minutes

Frequency: Weekly (tapering)

Typical course: 15–25 sessions

Between sessions: Family meal support, monitoring, nutrition plans

Common uses and suitability

What problems it is commonly used for

Adolescent anorexia nervosaSome presentations of bulimia nervosa in adolescentsRestrictive eating disorders where family involvement is feasible

Who this therapy may suit best

Adolescents living at home
Families able to engage actively and consistently
Cases where early intervention is possible

When it may need adapting or may not be suitable

Older adolescents/young adults living independently
High family conflict without additional systemic work
Severe comorbidity requiring parallel specialist input

Where this therapy may not be enough

FBT is designed for young people with family involvement. Adult anorexia requires different approaches. Severe comorbidity may need additional parallel treatment.

What happens in therapy

Externalisation

Separating the eating disorder from the person — seeing it as something external that has taken hold, not as the person’s identity.

Family Meal Session

A session where the family brings a meal and the therapist observes and coaches in real time.

Phase-Based Structure

Therapy follows three clear stages: parents leading nutrition, gradually returning control, then supporting independence.

Evidence Base

Guideline support

Strong for adolescent anorexia. NICE NG69 recommends family therapy (including FBT) as a first-line treatment for children and young people with anorexia nervosa.

Strength of evidence

Strongest for adolescent anorexia nervosa. Multiple RCTs support efficacy.

Limitations

Requires service capacity and family engagement. Not one-size-fits-all. Less evidence for older adolescents and adults.