Phase 1 treatment for the chronic and previously treated anorexia. Bulimia nervosa patient

Abstract

Treatment of anorexia nervosa/bulimia patients with a chronic course who previously were treated is given little attention in the literature. At the Uppsala University Hospital, a special program was developed for this category. It is assumed that successful therapy requires (1) a combination of therapeutic modalities, (2) a stepwise treatment, (3) a combination of anorexia nervosa and bulimia treatment principles, and (4) a treatment goal that is subjectively valid for the patient. In the present article, “Phase 1” is described. This involves teaching eating control through detailed diet and activity regimens supported by daily talk sessions, body‐awareness therapy, and occupational therapy. “Phase 2” psychotherapy is thereby made possible. Results are promising in that a substantial proportion of patients were able to reach eating and weight goals not attained in previous treatments. Possible ways of improving results, the role of medical management, and implications for treatment of young patients are discussed.

Mortality of eating disorders: A follow‐up study of treatment in a specialist unit 1974–2000

“…This 12 week in-patient program emphasized control of eating through a detailed diet and activity regime combined with daily therapy sessions. 7 Patients were admitted for both secondary care within the catchment area of UUH (0.3 million inhabitants) and following referral for tertiary care from the rest of Sweden (average population about 8.5 millions during the study period). The national patients were admitted as a last resort for persons considered as chronically ill with severe symptoms and a long history of ED, also among local patients many had longstanding severe ED symptoms and co-morbidity.…”

Biochemical parameters in identifying patients with anorexia and bulimia nervosa

“…Binge eating is characterized by an irresistible urge to overeat large quantities of food in a short time, which is often accompanied by purging, usually vomiting or laxative abuse. The purging serves as a means to counteract the consequences of binge eating; the weight phobia is the central core in restricting both anorectics and bulimics (Holmgren et al, 1984). A variety of theories and hypotheses have been put forward, but still the origin or direct cause of eating disorders remains obscure.…”

A randomised trial of Acceptance and Commitment Therapy for Anorexia Nervosa after daycare treatment, including five-year follow-up

“…Rest and food exposure with support to start eating was the base for daycare . The rationale, format, combination of the professional team as well as methods and strategies used within this daycare unit are described in Holmgren et al [ 30 ]. After completing the first nine weeks, an additional and optional 3-week weight gain program was available for all participants before the ACT or TAU treatment started.…”