The anorexigenic family. A systemic view of eating disorders

Abstract

Eating disorders (ED) are multifactorial mental disorders with a higher incidence in adolescence and in the female sex, in which certain family factors —communication difficulties, overprotection, a history of obesity— exert a relevant influence. From the perspective of systemic therapies, the symptom is understood as the result of a failure in the family structure and the family is incorporated into the therapeutic process. We present the case of a 14-year-old woman admitted to an adolescent unit for ED symptoms with a loss of 15 kg in four months (BMI 15.4 kg/m²), restrictive eating behaviour, abdominal body dysmorphia and feelings of guilt associated with conflicts between her parents. After assessment according to Marjory Gordon’s functional health patterns, with observation and a semi-structured interview of the patient and the family, a care plan was developed with the NANDA, NOC and NIC taxonomies (ineffective role performance, disturbed body image and readiness for enhanced health management). Over four weeks the patient completed her meals, improved her mood, sleep and communication, and was referred to the day hospital to work on the psychotherapeutic aspects, illustrating the value of the systemic and family perspective.