Anorexia nervosa is a serious disease caused by excessively reduced food intake, usually in an attempt by young people, particularly girls, to lose weight. It follows a prolonged course with a high morbidity rate due to major medical complications resulting from the severe malnutrition it engenders (Le Grange, 1999). Anorexia nervosa is not a new disease, being reported in the medical literature for the last 300 years (Crosscope-Happel, Hutchins, Getz and Hayes, 2000). The excessive weight loss in anorexia nervosa leads to endocrine malfunction and is usually accompanied by a specific psychopathology in which the patients develop an obsessive fear of fat. Treatment usually involves refeeding during an inpatient stay of from 10 to 14 weeks, and after discharge from the hospital, supportive psychotherapy, nutritional counseling and regular monitoring of weight and physical health. However, the relapse rate is quite high after hospital discharge.
Because of the scarcity of research into the efficacy of psychotherapy in helping anorexia nervosa patients, Le Grange (1999) carried out a study of 80 anorexia nervosa patients on the effects of family therapy on these patients because it is thought that a dysfunctional family is often a contributory factor in the development of the disorder. He used patients on individual therapy as controls. This theory has been in vogue since the 1970s. Le Grange used a three part approach, first encouraging refeeding of the patient, perhaps even spending a few mealtimes with the family to observe family interactions and attitudes towards the patient. The second phase followed a patient's acceptance of refeeding and a change in the family's attitude to the problem, becoming cooperative and less critical. The final phase occurred when a healthy weight has been achieved and helped establish patient autonomy from the family, and the establishment of family boundaries. Le Grange describes in detai...