Management of eating disorders.
Berkman ND, et al.
Evid Rep Technol Assess (Full Rep). 2006 Apr;(135):1-166.
OBJECTIVES: The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), harms associated with treatments, factors associated with the treatment efficacy and with outcomes of these conditions, and whether treatment and outcomes for these conditions differ by sociodemographic characteristics.
DATA SOURCES: We searched MEDLINE, the Cumulative Index to Nursing and Applied Health (CINAHL), PSYCHINFO, the Educational Resources Information Center (ERIC), the National Agricultural Library (AGRICOLA), and Cochrane Collaboration libraries.
REVIEW METHODS: We reviewed each study against a priori inclusion/exclusion criteria. For included articles, a primary reviewer abstracted data directly into evidence tables; a second senior reviewer confirmed accuracy. We included studies published from 1980 to September 2005, in all languages. Studies had to involve populations diagnosed primarily with AN, BN, or BED and report on eating, psychiatric or psychological, or biomarker outcomes.
RESULTS: We report on 30 treatment studies for AN, 47 for BN, 25 for BED, and 34 outcome studies for AN, 13 for BN, 7 addressing both AN and BN, and 3 for BED. The AN literature on medications was sparse and inconclusive. Some forms of family therapy are efficacious in treating adolescents. Cognitive behavioral therapy (CBT) may reduce relapse risk for adults after weight restoration. For BN, fluoxetine (60 mg/day) reduces core bulimic symptoms (binge eating and purging) and associated psychological features in the short term. Individual or group CBT decreases core behavioral symptoms and psychological features in both the short and long term. How best to treat individuals who do not respond to CBT or fluoxetine remains unknown. In BED, individual or group CBT reduces binge eating and improves abstinence rates for up to 4 months after treatment; however, CBT is not associated with weight loss. Medications may play a role in treating BED patients. Further research addressing how best to achieve both abstinence from binge eating and weight loss in overweight patients is needed. Higher levels of depression and compulsivity were associated with poorer outcomes in AN; higher mortality was associated with concurrent alcohol and substance use disorders. Only depression was consistently associated with poorer outcomes in BN; BN was not associated with an increased risk of death. Because of sparse data, we could reach no conclusions concerning BED outcomes. No or only weak evidence addresses treatment or outcomes difference for these disorders.
CONCLUSIONS: The literature regarding treatment efficacy and outcomes for AN, BN, and BED is of highly variable quality. In future studies, researchers must attend to issues of statistical power, research design, standardized outcome measures, and sophistication and appropriateness of statistical methodology.
PICKY EATERS CLINIC Klinik Khusus Kesulitan Makan Pada Anak dan GROW UP CLINIC Klinik Khusus Gangguan Pertumbuhan Berat Badan Anak Yudhasmara Foundation www.pickyeaterschild.wordpress.com/ email : firstname.lastname@example.org
WORKING TOGETHER FOR STRONGER, HEALTHIER AND SMARTER CHILDREN BY EDUCATION, CLINICAL INTERVENTION, RESEARCH AND NETWORKING INFORMATION. Advancing of the future pediatric and future parenting to optimalized physical, mental and social health and well being for fetal, newborn, infant, children, adolescents and young adult
CHILDREN GROW UP CLINIC I
- CHILDREN GROW UP CLINIC I, JL Taman Bendungan Asahan 5 Bendungan Hilir Jakarta Pusat 10210 Phone : 5703646 – 44466102
- CHILDREN GROW UP CLINIC II, MENTENG SQUARE Jl Matraman 30 Jakarta Pusat 10430 Phone 44466103 – 97730777
|LAYANAN KLINIK KHUSUS “CHILDREN GRoW UP CLINIC”
PROFESIONAL MEDIS “CHILDREN GRoW UP CLINIC”
Clinical – Editor in Chief :
Dr WIDODO JUDARWANTO, pediatrician
- email : email@example.com
- curriculum vitae
- For Daily Newsletter join with this Twitter https://twitter.com/WidoJudarwanto
Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider
Copyright © 2012, Picky Eaters and Grow Up Clinic, Information Education Network. All rights reserved