Meta‐analysis on the efficacy of psychological treatments for anorexia nervosa

Abstract

Objective This meta‐analysis examines the efficacy of recently developed psychological treatments for anorexia nervosa, compared with control condition. Outcome criteria are weight gain, eating disorder pathology, and quality of life. Method Twelve thousand nine hundred ninety‐seven abstracts, published between 1980 and 2017, were retrieved. End‐of‐treatment data from 1,279 participants, from 15 of 17 eligible studies, were used to calculate pooled‐effect sizes (Hedges' g) for outcome using random‐effects model. Subgroup analyses were used to explore the influence of various patient and study characteristics. Results No significant differences between psychological treatment and controls were found on weight gain, g = 0.07, 95% CI [−0.09, 0.23], eating disorder pathology, g = 0.06, 95% CI [−0.10, 0.21], and quality of life, g = −0.11, 95% CI [−0.36, 0.15]. Studies including only patients over 18 years of age were more effective on weight gain than studies including adolescents as well. High‐quality studies and studies with reported therapist training had larger effects on weight gain and quality of life compared with low‐quality studies and studies without reported training. Conclusions Despite progress in the development of specialized treatments, the efficacy of psychological treatment over an active control condition could not be established. Outcomes, however, are obscured by low‐quality and heterogeneous studies.

Implementing cognitive behavioral therapy‐enhanced in a routine inpatient and outpatient setting: Comparing effectiveness and treatment costs in two consecutive cohorts

“…The finding that, on clinical outcome, no significant differences were found between a specialized psychological treatment, like CBT-E, and TAU is in line with the literature (Hay, Claudino, Touyz, & Abd Elbaky, 2015;van den Berg et al, 2019), both anorexia reviews stated that difficulties in establishing differences may be due to the nature of an optimized TAU consisting of recommended, multimodal interventions, such as engaging the patient, nutritional and physical rehabilitation, and establishing a regular eating pattern.…”

Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial

“…Prevailing guidelines for the treatment of eating disorders (ED) endorse cognitive behavior therapy (CBT) as psychological treatment of first choice, especially for bulimia nervosa (BN) and binge‐eating disorder (BED) (Hay et al, ; Hilbert, Hoek, & Schmidt, ; National Institute for Health and Care Excellence (NICE), ; Yager et al, ). The effectiveness of CBT for anorexia nervosa (AN) is less pronounced, however this should be understood in the context of similar, somewhat disappointing, outcomes of other therapies for AN (van den Berg et al, ; Waller, ). CBT‐Enhanced (CBT‐E) is a specific form of CBT suitable for the full range of eating disorder diagnoses (Fairburn, ).…”

The impact of COVID‐19 epidemic on eating disorders: A longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls

“…From this perspective, patients with eating disorders (EDs) seem to represent a particularly vulnerable population to the effect of the unexpected environmental conditions during the COVID-19 pandemic, considering their specific psychopathology and the need for a continuous assistance in the active phase of their disorders (Touyz, Lacey, & Hay, 2020;Weissman, Bauer, & Thomas, 2020). Indeed, the reduction of treatment implementation and the confinement have been hypothesized to possibly worsen psychological stress and the severity of ED specific symptomatology (Dalle Grave, 2020; Murphy, Calugi, Cooper, & Dalle Grave, 2020;Peckmezian & Paxton, 2020;Van den Berg et al, 2019).…”