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Living With Food: The Science Supporting Eating Disorder Treatment

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What Is Evidence-Based Treatment?

Posted by Mark Warren on Fri, Sep 11, 2009 @ 11:53 AM
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The term “evidence-based treatment” refers to therapy that has demonstrated statistically significant improvements or changes in behavior. In most kinds of healthcare, the only kind of treatment a person would accept is something that is evidence based. If someone was getting treatment for cancer, diabetes, or another life threatening illness, they would seek out care that had significant evidence that it worked. Unfortunately, the history of psychiatric treatment is filled with ineffective care used because it was marketed well or because there was nothing else available. Luckily this is no longer true.

Evidence-based therapy for the treatment of eating disorders has only existed for the past 15 years. Although various types of therapy have been proven to show progress in some clients, evidence to support any given treatment is not as good as we would like it to be. It is, however, better than it used to be. The major limitations to research are the short length of many trials in what we now know are long term illnesses, and the difficulty of doing randomized controlled clinical trials. Nonetheless, given that there was no effective treatment prior to 15 years ago, what we know now is a significant improvement.

For adults, evidence-based treatments include Cognitive-behavioral therapyDialectical-behavioral therapy,and Interpersonal therapy. If you are 18 years or older and are currently suffering from an eating disorder, these are the therapies to try first. If you are under the age of 18 and have anorexia, the Maudsley method is the only treatment that is evidence-based and should therefore be tried prior to any other treatment. We will cover each of these treatments separately over the next few weeks.

 

Next week: How can I tell if my therapy is working?

 

 

Contributions by Sarah Emerman 

 

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COMMENTS

This is so helpful. We really appreciate the information about approaches to the problems of our adolescent. Please write more about family centered therapy for children with eating disorders

posted @ Sunday, September 13, 2009 6:54 PM by Louis


Thank you for your comment, Louis. Please stay tuned for future posts where we will be discussing the Maudsley method for family based treatment in detail.

posted @ Monday, September 14, 2009 1:49 PM by Sarah


Therapy has been so useful for my daughter. We are very worried now that she is off to college. What can we do to insure we don't lose ground while she's away at school?

posted @ Monday, September 14, 2009 6:14 PM by Theresa


Our doctor wants to put our daughter on zyprexa for her anorexia. He says that he read about some study in Canada that suggests that this helps with some of the obsessive thinking that goes along with it. We've been concerned about some of the other things that have been in the newspaper about the dangers of zyprexa in teenagers. Is this drug really helpful?

posted @ Tuesday, September 15, 2009 7:50 AM by Lisa


Lisa- Zyprexa may be helpful, but it has been studied primarily in the context of intensive levels of care. If your daughter needs Zyprexa, she should also be in intensive behavioral (family) therapy.

posted @ Tuesday, September 15, 2009 9:21 AM by Mark Warren


Theresa- Great question without a simple answer. The transition to college is complex. She should have a treatment plan in place there. The Maudsley Parents website has a lot on this topic. Good luck.

posted @ Tuesday, September 15, 2009 9:23 AM by mark warren


I'm not sure what to do about my husband's insistence that our son try out for the wrestling team this fall. His school needs someone in his weight class but I'm worried that his disease may have left him with weak bones. I understand this may help his male self image but I don't want him getting hurt. Do you have any guidance on how to determine if this is going to be safe for him?

posted @ Saturday, September 26, 2009 12:59 PM by Brenda


Medical questions are crucial and should typically be directed to your son's primary care physician. In this case, a doctor may order a bone density scan to gauge how the eating disorder may have affected his bones. Thank you for your question and please continue to read our blog for more information on eating disorders.

posted @ Monday, September 28, 2009 8:08 PM by Mark Warren


hi, 
 
 
 
how do i find an evidence based treatment specific to anorexia in adults? most of these therapies when looked into more closely target bulimia. ive tried most therapies i.e cbt/crt/cat etc so far without sucess - getting tired of therapy and this illness - does anyone know? thanks

posted @ Friday, February 12, 2010 1:45 PM by natali


CBT, DBT and IPT have evidence basis. If you are anywhere nearby, please come for an assessment- we can try and figure out what might be helpful. If you are at a distance, let us know where and we will try and find resources. And don't give up hope. More good things happen every day.

posted @ Saturday, February 13, 2010 1:24 AM by mark warren


hi mark, well i live in the UK and i guessing you're in the US? I really seem to have exhausted all the therapy options here anyway. I am confident that its biological and they are finding new things everyday but I dont know how to manage it in the meantime. I just cant switch it off. It never shuts up no matter what I try. If I had insurance I would fly to the US coz it rubbish here. flights are no problem as my family are airline crew but the rest is the problem i guess. I recently had a eeg done so am awaiting on the report from that though i am desperate to get an fmri - at least if I could see it - something might help me figure out how to make it stop! Ive had 10years of hospital,relapse and therapy - what shall I do? Im so tired of it. 
 
 
 
Natali

posted @ Saturday, February 13, 2010 5:05 AM by natali


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