Remuda Ranch Programs for Eating and Anxiety Disorders has experienced an increase in treating twins with eating disorders. "The twin relationship can be a unique one," says Amy Gerberry, director of clinical services at Remuda Ranch. "There is often a stronger need for comparing and competition with one another. Because twins spend a lot of time together, they tend to want to do the same things together, and that can include eating."

Because siblings will often have some degree of competitiveness among them, eating disorders can be a way to "stand out" from siblings or sometimes mimic siblings. Additionally, there can be an inner conflict between the desire to be individuals and the fear of separation.

"Whether or not eating disorders are genetic, people can pick up behaviors from one another and that's why we see eating disorders running in families due to environment," says Gerberry. "It's also important to note that there is a genetic link with anxiety, and anxiety issues are often found in individuals with eating disorders."

Treatment for twins at Remuda Ranch follows the same modality as treating individuals with eating disorders, but there is a stronger focus on relationship dynamics and many times, interventions are individualized. "It's important for parents to realize that they are role models for their children," says Gerberry. "Children are listening when parents don't always realize it. A parent's thoughts and opinions on body image, exercise and healthy eating can be passed on to the children and even distorted. If families don't practice good communication or healthy emotion regulation, then an eating disorder has more of an opportunity to thrive, especially among twins."