A systematic review of family caregiving in eating disorders

• A systematic review on family caregiving in EDs was carried out and new 29 studies were identified.
• Most of the research has focused on mothers and the impact on fathers or others has been less studied.
• Findings found the high impact that living with an ED has on multiple aspects of family functioning.
• Association between the illness duration and caregiving experiences varied by stage of illness.
• Interesting preliminary cultural and gender differences emerged.

The objective of the study was to review systematically the available new evidence on family caregiving in eating disorders (ED), updating the study of Zabala, Macdonald, and Treasure (2009). Electronic databases were searched from October 2008 until May 2013. Selected studies included carers of people with ED and employed one or more measures of caregiving experience, accommodation and enabling behaviours, expressed emotion, and/or psychological distress. Twenty-nine studies were identified. Most of the studies examined these features in mothers of patients with anorexia. Only a few studies included a control group. The majority of studies found high levels of negative aspects of caregiving, accommodation and enabling behaviours, expressed emotion and psychological distress in carers of people with ED, although positive aspects and emotions were also reported. These features varied depending on some sociodemographic and clinical characteristics of carers and patients; moreover, interesting preliminary cultural and gender differences emerged. Progress has been made in research on family caregiving in ED and there is evidence that these factors can be associated with the outcome of ED. Theoretical, research and clinical implications of the findings are discussed.