New psychotherapy has potential to treat majority of cases of eating disorders

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Public release date: 15-Dec-2008

http://www.eurekalert.org/pub_releases/2008-12/wt-nph121208.php

Contact: Craig Brierley

c.brierley@...

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Wellcome Trust

New psychotherapy has potential to treat majority of cases of eating

disorders

Wellcome Trust researchers have developed a new form of psychotherapy

that has been shown to have the potential to treat more than eight out

of ten cases of eating disorders in adults, a study out today reports.

This new " enhanced " form of cognitive behavioural therapy (CBT-E) builds

on and improves the current leading treatment for bulimia nervosa as

recommended by the National Institute of Health and Clinical Excellence

(NICE). CBT-E is the first treatment to be shown to be suitable for the

majority of cases of eating disorders.

According to NICE, eating disorders are a major cause of physical and

psychosocial impairment in young women, affecting at least one in twenty

women between the ages of 18 and 30. They also occur in young men but

are less common. Three eating disorders are recognised: anorexia

nervosa, which accounts for around one in ten cases in adults; bulimia

nervosa, which accounts for a third of all cases; and the remainder are

classed as " atypical eating disorders, which account for over half of

all cases. In these atypical cases the features of anorexia nervosa and

bulimia nervosa are combined in a different way.

The three eating disorders vary in their severity, but typically involve

extreme and relentless dieting, self-induced vomiting or laxative

misuse, binge eating, driven exercising and in some cases marked weight

loss. Common associated features are depression, social withdrawal,

perfectionism and low self-esteem. The disorders tend to run a chronic

course and are notoriously difficult to treat. Relapse is common.

This new treatment derives from an earlier form of CBT that was designed

exclusively for patients with bulimia nervosa. Both were developed by

Professor Fairburn, a Wellcome Trust Principal Research

Fellow at the University of Oxford. In 2004, the earlier treatment

became the first psychotherapy to be recognised by NICE as the leading

treatment for a clinical condition and its use was recommended across

the NHS.

Now, in a study published today in the American Journal of Psychiatry,

Professor Fairburn and colleagues have shown that the enhanced version

of the treatment is not only more potent than the earlier

NICE-recommended treatment, but it can also be used to treat both

bulimia nervosa and the atypical eating disorders, making it suitable

for over 80 percent of cases of eating disorders.

" Eating disorders are serious mental health problems and can be very

distressing for both patients and their families, " says Professor

Fairburn. " Now for the first time, we have a single treatment which can

be effective at treating the majority of cases without the need for

patients to be admitted into hospital. "

154 people were recruited for the study which was based in Oxfordshire

and Leicestershire. Two versions of CBT-E were compared: a simple

version that focused solely on the eating disorder and a second, more

complex version that simultaneously addressed commonly associated

problems such as low self-esteem and extreme perfectionism. Both

treatments comprised twenty 50-minute outpatient appointments over

twenty weeks

The researchers found that the majority of patients responded well and

rapidly to the two forms of CBT-E and that the changes were sustained

over the following year, the time at which relapse is most likely to

occur. Approximately two-thirds of those who completed treatment made a

complete and lasting response with many of the remainder showing

substantial improvement. Patients with bulimia nervosa or an atypical

eating disorder responded equally well, though a planned sub-analysis

showed that patients with particularly complex clinical features

responded better to the more complex treatment and vice versa.

" This new psychotherapy is an effective and relatively straightforward

intervention for treating most clinical disorders seen in adults, " says

Professor Fairburn. " It is increasingly being used across the NHS and

has the potential to improve the lives of the hundreds of thousands of

people living with eating disorders. "

Professor Fairburn and colleagues are also nearing the completion of a

large-scale trial investigating the effectiveness of CBT-E as a

treatment for anorexia nervosa, the interim result of which look very

promising.

The findings have been welcomed by Ringwood, Chief Executive

Officer of Beat, the beating eating disorders campaign group: " This

research shows that people can benefit from psychological therapy even

at a very low weight. There has been so little research into eating

disorders and anorexia in particular, and Professor Fairburn's work has

really added to our knowledge in this challenging field. "

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The research is the culmination of a seven-year study funded by the

Wellcome Trust, the UK's largest medical research charity.

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

" Eat well, stay well with Parkinson's disease "

" Parkinson's disease: Guidelines for Medical Nutrition Therapy "

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