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Control of Eating Behavior Using a Novel Feedback System

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Treating severe and enduring anorexia nervosa: a randomized controlled trial.

S Touyz¹, D Le Grange, H Lacey

¹School of Psychology and Centre for Eating and Dieting Disorders (Boden Institute), School of Psychology, University of Sydney, NSW, Australia.

Psychological Medicine

|May 7, 2013

Summary

Cognitive Behavioral Therapy (CBT-AN) and Specialist Supportive Clinical Management (SSCM) both improved severe and enduring anorexia nervosa (SE-AN) outcomes. CBT-AN showed greater social adjustment and readiness for recovery at follow-up.

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Area of Science:

Psychiatry
Clinical Psychology
Eating Disorders Research

Background:

Severe and enduring anorexia nervosa (SE-AN) lacks evidence-based treatments.
This study addresses the treatment gap for adults with SE-AN.

Purpose of the Study:

To evaluate the relative efficacy of cognitive behavioral therapy for anorexia nervosa (CBT-AN) versus specialist supportive clinical management (SSCM) in adults with SE-AN.
To compare outcomes including quality of life, mood, and social adjustment.

Main Methods:

A multi-site randomized controlled trial (RCT) involving 63 participants with a diagnosis of anorexia nervosa (AN) and at least a 7-year illness history.
Participants received 30 outpatient visits of either CBT-AN or SSCM over 8 months.
Assessments included quality of life, mood disorder symptoms, social adjustment, weight, eating disorder psychopathology, motivation for change, and healthcare burden at baseline, end of treatment, and 6- and 12-month follow-ups.

Main Results:

Both CBT-AN and SSCM groups showed significant improvements at end of treatment (EOT) and follow-up, with no differences at EOT.
At 6-month follow-up, CBT-AN demonstrated superior social adjustment (Weissman Social Adjustment Scale).
At 12-month follow-up, CBT-AN showed lower Eating Disorder Examination (EDE) global scores and higher readiness for recovery compared to SSCM.

Conclusions:

Both CBT-AN and SSCM are acceptable and effective treatments for severe and enduring anorexia nervosa (SE-AN), achieving high retention rates.
While both therapies yield improvements, CBT-AN demonstrated specific advantages in social adjustment and recovery motivation at longer-term follow-up.
Findings suggest treatment differences align with the distinct therapeutic approaches of CBT-AN and SSCM.