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Dietitians using Family Based Treatment (FBT): Strategies and guidance

Saturday, February 9, 2019: 4:00 PM-5:30 PM
Desert Salon 1/2 (JW Marriott Desert Springs Resort and Spa)

Background: Family-based Treatment (FBT) is recommended for adolescent anorexia nervosa, yet limited access to trained clinicians hampers dissemination. Meanwhile, dietitians experienced in eating disorders are an untapped resource for delivering evidence-based practice (EBP) based on FBT. Presenters will discuss how to involve dietitians to enhance FBT: collaborative use of dietitians as consultants for caregivers and the multidisciplinary team; dietitians leading the renourishment aspect of treatment; and dietitians using modified versions of FBT to treat eating disorders. Presenters will also address crisis management of escalating emotion and interpersonal conflict as well as the international evolution of FBT.


  1. Describe key features of the guidelines for dietitians treating eating disorders using an FBT approach
  2. Evaluate the pros and cons of delivery of FBT techniques by dietitians in the treatment of child and adolescent eating disorders
  3. Discuss solutions to increase the adoption and implementation of FBT by eating disorder treatment providers

  • Introduction: Linking FBT to Dietetic Practice
    • Tenets and Phases of FBT
    • Key Principles for the Dietitian Practicing FBT
    • Why (Dietitians Can) Embrace FBT?
  • Content:
    • EBP (Evidence-based Practice) and EBT (Evidence-based treatments) explained in relation to dietitian use of FBT
    • Challenges: Avoiding Landmines and Role Delineation
    • Ways Dietitians can Enhance FBT Practice and Ways FBT can Enhance Dietetic Practice
      • Building Bridges
      • Talking about Scary Things
      • The Evolution of Dietetic Practice: approaches in UK compared with US
  • Small Group Discussion
    • Case Studies
  • Large Group Discussion
  • Concluding Remarks & Resources

Eating disorder clinicians are encouraged to employ evidence-based practice (EBP). EBP is established from research on efficacy and effectiveness of interventions that evolve from evidence-based treatments (EBT), like Family-Based Treatment (FBT). The distinction between EBT and EBP has implications for the use of FBT by dietitians. FBT is treatment of choice for anorexia nervosa in children and adolescents, yet dissemination of FBT is hampered by many barriers. Dietitians experienced in eating disorder treatment and who have studied FBT are a potential untapped resource for expanding delivery of EBP based on FBT. The speakers will describe ways dietitians can be involved in FBT: collaborative use of dietitians as consultants for parents/caregivers, therapists, and the multidisciplinary team; dietitians leading the renourishment aspect of treatment in conjunction with a therapist who focuses on family dynamics and developmental and emotional issues; and dietitians using modified versions of FBT to treat eating disorders. Additionally, presenters will provide training on managing escalating crises of emotion and interpersonal conflict. FBT treatment and dietetic practice in eating disorders is evolving differently in the UK and US; differences in the approaches will be presented. Guidelines for dietitians using FBT will be discussed and demonstrated with case studies.
Primary Presenter:
Bryan Lian, MS RD CEDRD

Bryan practices at Stanford’s student health center and health promotion services. He also has a private practices based in the Bay Area in California. He has also written a paper for the Journal of the Academy of Nutrition and Dietetics on Family Based Treatment and Dietitians, based on his work at Lucile Packard Children’s Hospital at Stanford Children’s Health. He completed his undergraduate degrees in biology/nutrition at Rutgers University, his dietetic internship at Beth Israel Deaconess Medical Center, his LEAH (Leadership Educators in Adolescent Health) fellowship at Boston Children’s hospital; and his 200hr Yoga teacher training.

Marcia Herrin, MPH, EdD, RDN, FAED

Dr. Herrin is founder of Dartmouth College’s nationally renowned eating disorder program. Dr. Herrin conducts a private practice in Lebanon NH and serves as a Clinical Assistant Professor at Dartmouth’s Geisel School of Medicine and Supervisor of Pediatric Residents, Children’s Hospital at Dartmouth. She authored Nutrition Counseling in the Treatment of Eating Disorders and Parent’s Guide to Eating Disorders. Marcia received higher degrees from Columbia University and the University of California-Berkeley. Marcia credits much of her success with patients with eating disorders and obesity to her own struggles with and recovery from these conditions.

and Anna Oliver, BSc, BPhEd, PGDipDiet, RD

Anna is a private practice dietitian based in London who has been working in the treatment for eating disorders in both adolescents and adults since 2006. She has developed a special interest in working with children and adolescents, and has aligned her practice with FBT whilst working within multidisciplinary teams and in her private practice. She is is currently a doctoral student in Systemic Family Studies. She is also taking a lead role within a working group which is establishing a FBT Dietetic manual to support the UK's National Eating Disorder Team Training.

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