Thank you for your very insightful comments!

The reason that I chose the Maudsley / evolution comparison is that, for both issues, some people continue to cling to other antiquated ideas despite all evidence to the contrary.

After some reflection, however, I have come to agree with you that the Maudsley / evolution comparison is not a great one. You’re right, there is a wealth of evidence supporting evolution, and certainly the amount evidence supporting Maudsley pales in comparison. The reason for this disparity is most likely because human beings have been asking the question “Where did we come from?” for thousands of years, whereas we have been asking “What is the most effective way to treat eating disorders?” for only a few decades.

You write: “What frustrates me often is when Maudsley advocates pretend that Maudsley is some god-sent treatment. It is not.” I think whether Maudsley is a “god-sent treatment” is a matter of opinion (what does god-sent mean, anyway?) and depends entirely on whom you ask. For the 75-90% of kids who go through Maudsley and recover within a year, often times after numerous failed hospitalizations and attempts at traditional treatment, it is a god-sent treament! And I’m sure their parents would agree! Remember, most Maudsley parents have already been through hell watching their child starve herself into oblivion, fearing for her life yet being told by traditional therapists to “stay out of it,” because the illness is somehow their fault. To a parent with a sick child, it is a god-send to be able to take an active role in the child’s treatment and help her recover in a relatively short period of time (compared with other treatments). And to me, as a research psychologist and clinician, it is a god-send to be able to use Maudsley to help kids recover from anorexia and become happy and healthy!

For the 10-25% of kids who don’t recover with Maudsley, and to their parents, Maudsley is certainly not a god-sent treatment.
Maudsley is NOT a panacea. It is not perfect. It is very difficult to implement. The majority of American families do not have access to Maudsley resources locally. It does not work for everyone. But, as you point out, it is absolutely the best treatment we’ve got right now. What little scientific literature we have right now supports fully. So I’ll continue to advocate for it until we find something more effective.

I’d like to offer the point here that Maudsley has hardly been supported or evaluated as strongly and long as evolution. I think this is a bad comparison. What frustrates me often is when Maudsley advocates pretend that Maudsley is some god-sent treatment. It is not. And it has hardly been supported by “a wealth of scientific literature”. On the contrary, Maudsley has been supported by some literature, and this is definitely a plus, considering it is the only treatment that has been shown effective in the ED literature, but it hardly stands to be compared to evolution. Evolution is known scientific phenomenon that has been proven over and over again. Maudsley is a treatment approach in a field that is (sadly enough) still very under researched and is relied upon as the only evidence based treatment simply because there is basically nothing else.

The second I saw the title to this post–without even reading–was the evolution vs. creationism debate. And you brought it up for me! That so-called debate is the one thing that gets my blood boiling faster than non-evidence-based views on EDs. (This is also the second most popular subject area for me to read about, behind EDs. I have a huge collection of evolution lit and Darwiniana on my bookshelf!). It’s also a debate I tend to charge into head-first, for better or worse.

LOVE this post!
Carrie

Your response to Julie is excellent. I hope it is published. I’m so glad your daughter has been able to recover through FBT. I wonder if the author may consider writing a similar article on FBT for young adults?

I sent this response to Julie. http://www.aroundthedinnertable.org/post/show_single_post?pid=40786312&postcount=13

I think attitudes about eating disorders have been entrenched for a long time.
If it takes a bit of “controversy” starts to stir the pot…so be it!

Thanks so much for your support for evidence based care. Patients deserve no
less!!!

Lydia

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