Effective interventions for adolescents with anorexia nervosa

Abstract

Background: Anorexia Nervosa (AN) is a serious psychiatric illness with both psychological and medical sequelae that usually onsets during adolescence. The illness presents formidable challenges to clinicians. Despite these facts, there are few treatments studies for the adolescent age group. Aims: This report provides a critical review of the most common treatments and the empirical support for them for adolescent AN. Method: Clinical and research literature was reviewed to identify empirically supported treatments with an emphasis on identifying pertinent randomized controlled trials. However, relevant clinically oriented reports and consensus clinical guidelines were also included when other systematic research was unavailable in order to provide a more comprehensive view of current treatment strategies for adolescents with AN. Results: There are only five randomized clinical trials specifically addressing treatment for adolescent AN. Only 207 subjects were enrolled in these studies with an average cell size of about 20 subjects. Data from these trials suggest that family therapy wherein parents re-feed their adolescent offspring is effective for AN in this age group. However, other treatment approaches (e.g. individual therapy, group therapy, hospitalization, medication) have not been sufficiently or systematically studied. Conclusions: Family therapy based on parental re-feeding is an effective approach for adolescent AN. However, the superiority of family therapy over other types of interventions has not been sufficiently demonstrated. There is an urgent need to conduct treatment research in this area to guide clinical care for this vulnerable population.

Food-related parenting practices and child and adolescent weight and weight-related behaviors

“…[45] In addition to the strong body of evidence that exists indicating the important role that parental behaviors and the family environment plays in the development of the weight status and weight-related behaviors of young people, parents have also been identified within research studies as having an integral role in the successful treatment of pediatric obesity[46] as well as clinical eating disorders in young people. [47,48]…”

A Psycho-Education Intervention for Parents of Adolescents With Eating Disorders: A Randomized Controlled Trial

“…Eating disorders can be difficult to treat; about 50% of patients do well over time, approximately 30% improve somewhat but continue to have significant symptoms, and approximately 20% do poorly (Katzman, 1999;Lock & Gowers, 2005). Despite slightly more favorable recovery rates in adolescents, eating disorders have the highest mortality rate of any psychiatric disorder, due to a combination of suicide and medical complications (Lucas, Beard, O'Fallon, & Kurland, 1991;Signorini et al, 2007;Steinhausen, 2009;Sullivan, 1995).…”

Anorexia Nervosa in Adolescence and Maudsley Family‐Based Treatment

“…Finally, manualized MFBT appears to be effective and acceptable to 78% of patients and families (Krautter & Lock, 2004), and completion rates over 80% were reported in the large studies (Lock & Gowers, 2005; Lock et al, 2010). In addition to the trials mentioned earlier, dissemination of MFBT beyond the treatment development sites in the United States and the United Kingdom appears to be successful (Couturier, Isserlin, & Lock, 2010; Loeb et al, 2007; Paulson‐Karlsson, Engstrom, & Nevonen, 2009; Wallis, Rhodes, Kohn, & Madden, 2007).…”