Family-based therapy for eating disorders: from the Milan model to contemporary evidence

Abstract

Family-oriented therapy has profoundly influenced the conceptualization and treatment of eating disorders over the past five decades. Beginning with systemic pioneers such as Mara Selvini Palazzoli and Salvador Minuchin, clinicians have increasingly viewed eating disorders not solely as intrapsychic disturbances but as relational phenomena embedded within family systems. These ideas led to structured, evidence-based models such as Family-Based Treatment (FBT) and Multifamily Therapy (MFT). This review summarizes historical milestones, theoretical innovations, and empirical findings on family-oriented interventions for eating disorders. The article also discusses mechanisms of change, clinical applications, and contemporary challenges in implementation and cultural adaptation of family based treatments. Some interesting research hypotheses are formulated regarding family support and neural circuitry during refeeding that can inspire future research.