FBT-TAY for Eating Disorders: Family-Based Treatment for Transitional Age Youth
How FBT-TAY Helps Young Adults Recover from Eating Disorders While Maintaining Independence
When a teen or young adult develops an eating disorder, families are often told conflicting things:
“Your child is legally an adult now.”
“They need independence.”
“Parents should step back.”
At the same time, the eating disorder may be rapidly taking over their life.
For many families, this creates confusion, fear, and helplessness—especially when a 17-, 18-, 19-, or 20-year-old is medically or psychologically deteriorating but still trying to maintain school, work, athletics, or college life.
This is where FBT-TAY, Family-Based Treatment for Transitional Age Youth, can help.
At Ezer Psychotherapy, we provide evidence-based outpatient treatment for eating disorders in children, teens, and young adults across Minnesota, Wisconsin, North Dakota, and Florida. We specialize in Family-Based Treatment (FBT) and FBT-TAY for adolescents and transitional-age youth struggling with anorexia nervosa, bulimia nervosa, ARFID, and other eating disorders.
What Is FBT-TAY?
FBT-TAY stands for Family-Based Treatment for Transitional Age Youth.
It is an adaptation of traditional Family-Based Treatment, designed specifically for older adolescents and young adults—typically ages 16–25. Rather than removing family involvement once someone turns 18, FBT-TAY recognizes that supportive relationships are often essential to recovery (Dimitropoulos et al., 2015; Dimitropoulos et al., 2018).
FBT-TAY keeps the core principles of traditional FBT while modifying treatment to fit the developmental needs of young adults. Research and clinical literature describe several important adaptations, including:
Greater collaboration
More autonomy and consent
Flexible caregiver involvement
Increased focus on independent functioning and relapse prevention
Instead of parents fully taking over nutrition as they might with a younger child, FBT-TAY emphasizes partnership, accountability, and developmentally appropriate support.
Who Is FBT-TAY For?
FBT-TAY may be appropriate for:
Older adolescents and young adults ages 16–25
College students struggling with eating disorders
Young adults living at home
Young adults returning home from college due to eating disorder symptoms
Individuals who want family involvement but still value autonomy
Families hoping to avoid residential or inpatient treatment when medically safe
Patients struggling with anorexia nervosa, bulimia nervosa, atypical anorexia, ARFID, or other eating disorders
FBT-TAY is especially helpful for young adults who intellectually “want recovery” but are unable to consistently interrupt eating disorder behaviors without support.
How FBT-TAY Differs From Traditional FBT
Traditional FBT is a well-supported first-line outpatient treatment for adolescents with anorexia nervosa and involves parents taking temporary leadership over meals and recovery behaviors (Lock et al., 2010; Society for Adolescent Health and Medicine, 2022).
However, transitional age youth are in a very different developmental stage than a 12-year-old child.
Young adults are often:
Driving
Working
Attending college
Dating
Living independently
Making legal and medical decisions for themselves
Because of this, FBT-TAY modifies treatment in several ways.
1. Greater Collaboration
Instead of treatment being done “to” the young adult, recovery is approached collaboratively.
The therapist, family, and young adult work together to determine:
What support is needed
How meals will be supported
What accountability looks like
How recovery responsibilities will gradually increase
Research on FBT-TAY emphasizes collaborative decision-making as one of the most important developmental adaptations (Dimitropoulos et al., 2015; Dimitropoulos et al., 2018).
2. Respect for Autonomy
FBT-TAY respects that the patient is emerging into adulthood.
Young adults are encouraged to:
Have a voice in treatment
Participate actively in recovery planning
Identify meaningful life goals
Build independent coping skills
At the same time, treatment recognizes that an eating disorder can significantly impair judgment, flexibility, and functioning.
3. Flexible Support Systems
Support in FBT-TAY does not always come only from parents.
Depending on the situation, supports may include:
Parents
Stepparents
Siblings
Partners
Roommates
Close friends
Other trusted adults
The goal is to create a recovery environment that reduces isolation and increases accountability. In FBT-TAY research, young adults were allowed to choose supportive others, although most chose family members (Dimitropoulos et al., 2018).
4. Focus on Adult Responsibilities
FBT-TAY addresses the real-life demands young adults face, including:
College dining halls
Work schedules
Independent meal planning
Dating and relationships
Social eating
Exercise
Transitioning into adulthood while recovering
Treatment includes helping young adults practice recovery skills in real-world settings.
Does FBT-TAY Work?
Research on FBT-TAY is still growing, but early findings are promising.
Pilot and open-trial research has demonstrated improvements in:
Eating disorder symptoms
Weight restoration
Family functioning
Caregiver confidence
One open trial found that participants showed significant improvement in eating disorder symptoms and maintained weight restoration at end of treatment and three-month follow-up, although the study was small and had a high dropout rate (Dimitropoulos et al., 2018).
Clinical literature also suggests that many transition-age youth want supportive family involvement when it is collaborative, respectful, and developmentally appropriate (Dimitropoulos et al., 2016).
What Families Often Experience During FBT-TAY
Families frequently arrive feeling:
Terrified
Exhausted
Confused
Unsure whether they are “allowed” to help
Many parents have been told they need to step back because their child is legally an adult. But eating disorders thrive in secrecy, isolation, and avoidance.
One central goal of FBT-TAY is helping families move from panic and helplessness into structured, compassionate support.
At the same time, it is important to acknowledge that treatment can feel emotionally intense for everyone involved. Qualitative research on family therapies for anorexia nervosa highlights both the importance of family involvement and the need for flexibility, emotional attunement, and attention to the young person’s broader development (Cripps et al., 2024).
Effective FBT-TAY is not about punishment or control.
It is about:
Restoring safety
Interrupting eating disorder behaviors
Rebuilding trust
Helping young adults reclaim their lives
FBT-TAY at Ezer Psychotherapy
At Ezer Psychotherapy, we provide specialized outpatient treatment for eating disorders in children, adolescents, and young adults.
Our approach to FBT-TAY is:
Evidence-based
Collaborative
Compassionate
Individualized to the developmental needs of each patient and family
We help families navigate:
Meal support
Symptom interruption
College transitions
Relapse prevention
Exercise concerns
Body image distress
Anxiety
Family communication
We also collaborate closely with:
Physicians
Dietitians
Psychiatrists
Pediatricians
Other members of the treatment team
Christian faith integration is available upon request for families who desire faith-based support as part of treatment.
Can FBT-TAY Be Done Virtually?
Yes. Telehealth FBT-TAY may be appropriate for many families, depending on medical stability, safety, privacy, and the ability to coordinate care.
Virtual treatment allows families to:
Receive support from home
Involve caregivers in multiple locations
Coordinate around college schedules
Access specialized eating disorder care when local providers are limited
Telehealth FBT has not been studied as extensively as in-person care, but emerging evidence and clinical guidance suggest it can be feasible and useful when adapted thoughtfully (Matheson et al., 2020; Drury et al., 2025).
Ezer Psychotherapy offers virtual eating disorder therapy in:
Minnesota
Wisconsin
North Dakota
Florida
When Higher Levels of Care May Be Needed
Outpatient FBT-TAY is often appropriate and effective, but some individuals may require a higher level of care if there is:
Medical instability
Acute suicidality
Inability to maintain safety
Severe purging
Acute food refusal
Failure to make progress outpatient
Medical factors that may support hospitalization include severe bradycardia, hypotension, hypothermia, electrolyte disturbance, dehydration, acute food refusal, uncontrolled bingeing or purging, or psychiatric symptoms that prevent safe outpatient care (Society for Adolescent Health and Medicine, 2022).
Our goal is always to help patients recover in the least restrictive environment that is safe and clinically appropriate whenever possible.
Eating Disorder Recovery Is Possible
Eating disorders can make families feel hopeless and disconnected.
But recovery is possible.
FBT-TAY helps families and young adults work together—not against each other—to restore nutrition, rebuild trust, and create a path forward into adulthood.
With appropriate support, many young adults are able to:
Return to school
Reconnect socially
Restore physical health
Rebuild identity outside the eating disorder
Move toward long-term recovery
If your teen or young adult is struggling with an eating disorder, Ezer Psychotherapy is here to help.
Schedule Eating Disorder Therapy
Ezer Psychotherapy provides outpatient therapy for:
Anorexia nervosa
Bulimia nervosa
ARFID
Binge eating disorder
Other eating disorders
Disordered eating
Rumination disorder
Body image concerns
We offer:
FBT-TAY
Family-Based Treatment
CBT-E
Adolescent Focused Therapy
Young adult therapy
Christian counseling options
Serving clients virtually in Minnesota, Wisconsin, North Dakota, and Florida.
Learn more on our website at https://ezerpsychotherapy.com
References
Agras, W. S., Lock, J., Brandt, H., Bryson, S. W., Dodge, E., Halmi, K. A., Jo, B., Johnson, C., Kaye, W., Wilfley, D., Woodside, B., & Le Grange, D. (2014). Comparison of 2 family therapies for adolescent anorexia nervosa: A randomized parallel trial. JAMA Psychiatry, 71(11), 1279–1286.
Cripps, S., et al. (2024). Processes of change in family therapies for anorexia nervosa: A systematic review and meta-synthesis of qualitative data. Journal of Eating Disorders.
Dimitropoulos, G., Freeman, V. E., Allemang, B., Couturier, J., McVey, G., Lock, J., & Le Grange, D. (2015). Family-based treatment with transition age youth with anorexia nervosa: A qualitative summary of application in clinical practice. Journal of Eating Disorders, 3, 1.
Dimitropoulos, G., Herschman, J., Toulany, A., & Steinegger, C. (2016). A qualitative study on the challenges associated with accepting familial support from the perspective of transition-age youth with eating disorders. Eating Disorders, 24(3), 255–270.
Dimitropoulos, G., Landers, A. L., Freeman, V., Novick, J., Garber, A., & Le Grange, D. (2018). Open trial of Family-Based Treatment of anorexia nervosa for transition age youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 27(1), 50–61.
Dimitropoulos, G., Landers, A. L., Freeman, V., Novick, J., Cullen, O., & Le Grange, D. (2019). Family-based treatment for transition age youth: The role of expressed emotion and general family functioning. Eating Disorders, 27(5), 419–435.
Dimitropoulos, G., Landers, A. L., Freeman, V., Novick, J., & Le Grange, D. (2018). Family-based treatment for transition age youth: Parental self-efficacy and caregiver accommodation. Journal of Eating Disorders, 6, 13.
Drury, C. R., et al. (2025). Comparing outcomes for telehealth versus in-person family-based treatment: A retrospective chart review. International Journal of Eating Disorders.
Lock, J., Le Grange, D., Agras, W. S., Moye, A., Bryson, S. W., & Jo, B. (2010). Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Archives of General Psychiatry, 67(10), 1025–1032.
Matheson, B. E., Bohon, C., Lock, J., & Le Grange, D. (2020). Family-based treatment via videoconference: Clinical recommendations for treatment providers during COVID-19 and beyond. International Journal of Eating Disorders, 53(7), 1142–1154.
Rienecke, R. D., & Le Grange, D. (2022). The five tenets of family-based treatment for adolescent eating disorders. Journal of Eating Disorders, 10, 60.
Society for Adolescent Health and Medicine. (2022). Medical management of restrictive eating disorders in adolescents and young adults. Journal of Adolescent Health, 71(5), 648–654.
