Specified Treatments for Anorexia

Eating disorder therapies worked best when emphasis shifted to improving quality of life

(RxWiki News) There are no easy fixes for eating disorders. But a new study may shed light on what types of therapy can be most effective at helping patients with anorexia.

A recent clinical trial tested two different types of therapies on a group of women with severe, long-term anorexia.

These results showed that both types of specified therapies helped patients reduce symptoms for at least one year. 

Rather than focusing on weight gain, like many previous studies, the goal of these two treatments was to improve quality of life for the patients.

"Seek a specialized therapist for eating disorders."

Stephen Touyz, PhD, from the Centre for Eating and Dieting Disorders at the University of Sydney in Australia, led an investigation into effective treatments for people with long-term, persistent anorexia nervosa.

Anorexia is an eating disorder characterized by a person’s obsession with being underweight. People with anorexia may restrict their food intake to the point of starvation and/or overexercise to burn off more calories than they have consumed.

According to the authors, mental health and medical communities have had a great deal of difficulty in effectively treating anorexia.

Severe and enduring anorexia nervosa, which can be life threatening, does not currently have any effective treatment methods.

For this study, 63 patients with at least a seven-year history of anorexia were enrolled into a clinical trial to test two types of therapeutic treatments for anorexia.

The participants were women, 18 years of age and older, who had had serious anorexia symptoms for at least 7 years.

The patients were randomly split into a cognitive behavioral therapy group and a specialist supportive clinical management group. Patients in both groups attended 30 outpatient visits over the course of eight months.

The researchers checked up on the patients six months and 12 months after the end of the eight-month trial to see how the patients were doing.

Quality of life measures included relief from symptoms of a mood disorder, such as anxiety or depression, adjusting well to social situations, motivation to change eating behaviors and other physical health problems.

In the cognitive behavioral therapy group, patients were taken through four phases:

  1. Specific strategies to start treatment and address issues of motivation to get better
  2. Strategies to address: weight gain, triggers for calorie restriction and ideas of body distortion
  3. Therapist-directed behavioral experiments to address any issues beyond eating and weight
  4. Therapists prepared patients to continue to use what they learned in therapy after the end of the trial

Homework was given at the end of each session, which was then addressed at the start of every following session.

In the specialists supportive clinical management group, patients were supported with the following:

  • Instructional material designed to increase motivation to get better
  • Treatment sessions built around what each patient brought to the session
  • Nutritional education and advice used to encourage behavioral changes

No homework assignments were given in the specialists supportive clinical management group.

At the start of the trial, patients in the cognitive behavioral therapy group had an average body mass index (BMI) of 16.3, and patients in the specialists supportive clinical management group had an average BMI of 16.1.

By the end of the trial, patients in the cognitive behavioral therapy group had an average BMI of 16.8, and patients in the specialists supportive clinical management group had an average BMI of 16.8.

During the follow-up six months after the trial, patients in the cognitive behavioral therapy group had an average BMI of 16.6, and patients in the specialists supportive clinical management group had an average BMI of 16.8.

One year after the end of the trial, patients in the cognitive behavioral therapy group had an average BMI of 17.0, and patients in the specialists supportive clinical management group maintained their average of 16.8

Six months after the end of the trial, patients in the cognitive behavioral therapy group had better social adjustment scores and lower eating disorder symptom scores compared to patients in the specialists supportive clinical management group.

It is important to note that 85 percent of the original group that qualified to be in the study finished the trial. Previous anorexia treatment studies have had much lower rates of participants sticking with the program through the end, according to the authors.

The study authors concluded that both treatment methods were acceptable and helped the patients make meaningful improvements.

This study was published in May in Psychological Medicine.

The Australian National Health and Research Council, the South West London and St George’s National Health Service Trust, the Butterfly Foundation and the University of Western Sydney provided funding for this project. No conflicts of interest were found.

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Review Date: 
May 21, 2013