Research on Effective Treatment Methods

Contributor: Leigh Bell, BA, writer for A Center for Eating Disorders

Truly effective treatment for eating disorders remains elusive, but recent research shows what is working to free people from this debilitating disease. Professionals normally treat eating disorders, regardless what type, with cognitive-behavioral therapy (CBT) in various settings, and sometimes, medication is included in the treatment program. Research has shown how and when these methods can most effectively be delivered.

Treatment is still not effective as we’d like with a recovery rate of roughly 50%. It’s estimated of those with anorexia, 25% remain chronically ill and, for up to 20%, the disease is fatal. So we have much to learn about the treatment of eating disorders.

Funding in Lieu of Federal Cuts

Unfortunately, federal funding for research into eating disorders is quite low at $28 million a year (less than $1 for each person diagnosed with an eating disorder) compared to, for example, $505 million for alcoholism and $328 million for depression. Respectively, that’s 18 and 12 times more research-funding than that for eating disorders.

Researchers are doing the best they can with this money and additional private funding; and they are making breakthroughs, especially in the genetic component of eating disorders. This may lead to improved prevention and/or treatment of eating disorders.

The Role of CBT

Currently many professionals treat eating disorders with CBT, which works from the theory that our beliefs and thoughts cause our actions, not outside things like other people, situations, or events. In CBT, the client and therapist work as a team to help the client change his/her behaviors by changing the thought process.

This is obviously helpful for eating-disordered behavior, which is often fueled by inner thoughts and beliefs, such as “I’m fat” or “I’m not worthy of food,” etc. CBT would work to change those thoughts.

The Effectiveness of CBT

CBT is recognized as the “most effective treatment” for bulimia, surpassing in successful outcomes the use of other psychotherapies and antidepressant medication, according to a large study of outcomes¹. Unfortunately, even with CBT, only about half of those with bulimia actually recover, researchers found.

Those who didn’t respond to CBT, though, were not as socially adjusted and had a lower body-mass index, indicating there are characteristics of people who will and won’t respond to CBT, but these characteristics are unknown.

Those with anorexia also positively respond to CBT. One study compared to groups of adults with anorexia, one had CBT and the other had only nutritional counseling². Those with nutritional counseling dropped out at a far greater rate (73%) than those with CBT (22%). Still, the researchers make a good point: “We know of no empirical support for any intervention for adult anorexia nervosa.”

Medication for Eating Disorder Treatment

Medication is often used in the treatment of eating disorders, however, the Federal Drug Administration has only approved Prozac (fluoxetine) for bulimia nervosa and, just this year, Vyvanse for binge-eating disorder (BED). Prozac and other antidepressants, along with anti-anxiety medications are still commonly used in treatment.

Still research shows those with anorexia experience little to no benefit from Prozac and other antidepressants. This puzzles researchers because anorexia often presents symptoms similar to depression and obsessive-compulsive disorder, both of which respond to antidepressants³.

The Maudsley Approach

The Maudsley treatment approach, which involves parents of adolescents (and sometimes adults) with eating disorders, appears to be quite successful in those with anorexia nervosa. Research finds almost 70% of teenagers with anorexia reached a healthy weight by the end of treatment; and 5 years after treatment 75-90% of patients are fully recovered and no more than 10-15% remain seriously ill⁴.

These results are dramatically better from the aforementioned statistics of 45% of those with anorexia either living chronically with the illness or dying because of it.

Eating disorders manifest in each individual for different reasons, so it’s understandable that one treatment type cannot successfully treat every eating disorder. Oftentimes, treatment programs are a mix of many treatment types.

Nutrition Therapy

Medical nutrition therapy, which involves working with a nutritional professional to develop and follow a healthy meal plan, can benefit someone’s recovery from an eating disorder, but the nutritional professional should understand the complexities of eating disorders⁵.

Art Therapy

Art therapy helps someone “learn how to appreciate who they are in the moment, explore reasons for their behaviors, and establish new barometers for self-acceptance,” says art therapist Dr. Deah Schwartz⁶.

Movement or dance therapy helps people with eating disorders, who often have a tendency to detach from feelings and focus on body distortions, reconnect with their body and respond healthfully to their body’s needs⁷.

Research also shows some success in treating eating disorders with dialectical behavior therapy, acceptance and commitment therapy, exposure response prevention, and interpersonal psychotherapy.

Community Discussion – Share your thoughts here!

What steps did you or your loved one take in order to reconnect with the body during treatment for disordered eating? Were you aware of the research happening on eating disorders? What impact has this research had on your personal recovery?

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About the Author:

Leigh Bell holds a Bachelor of Arts in English with minors in Creative Writing and French from Loyola Marymount University in Los Angeles. She is a published author, journalist with 15 years of experience, and a recipient of the Rosalynn Carter Fellowship for Mental Health Journalism. Leigh is recovered from a near-fatal, decade-long battle with anorexia and the mother of three young, rambunctious children.

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References:

1. Agras, W. S., Crow, S., Halmi, K., Mitchell, J., Wilson, G.T., Karemer, Helena. (2000). Outcome predictors for behavior treatment of bulimia nervosa: Data from a multisite study. The American Journal of Psychiatry, 157(8), 1302-1308.
2. Pike, K., Walsh, B.T., Vitousek, K., Wilson, G.T., Bauer, J. (2003). Cognitive behavior therapy in posthospitalization treatment of anorexia nervosa. The American Journal of Psychiatry, 160(11), 2046-2049.
3. Attia, E., Haiman, C., Walsh, B.T., Flater, S., (1998). Does fluoxetine augment the inpatient treatment of anorexia nervosa? The American Journal of Psychiatry, 155(4), 548-551.
4. Le Grange, D. (2005) The Maudsley family-based treatment for adolescent anorexia nervosa. World Psychiatry, 4(3), 142-146.
5. American Dietetic Assocation. (2001). J Am Diet Assoc. 2001 Jul;Position of the American Dietetic Association: nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified (EDNOS). Journal of American Dietetic Association, 101(7), 810-9.
6. Schwartz, D. (2014, March 21). Expressive Arts Therapy and Eating Disorders | National Eating disorders Association. Retrieved June 29, 2015.
7. Krantz, Anne. (1999). Growing into her body: Dance/movement therapy for women with eating disorders. American Journal of Dance Therapy, 21(2), 81-103.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on July 22nd, 2015
Published on EatingDisorderHope.com