Treatment interventions for Severe and Enduring Eating Disorders: Systematic review

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• A significant percentage of individuals with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) develop long-standing illnesses, termed Severe and Enduring eating Disorders (SE-ED).
• SE-ED is characterized by prolonged disorder duration and multiple failed treatment attempts, with limited research on effective interventions.
• This systematic review addresses the scarcity of evidence for SE-ED treatments.

Purpose of the Study:

• To systematically review and synthesize existing research on various treatment interventions for Severe and Enduring eating Disorders (SE-ED).
• To evaluate the effects of different interventions on SE-ED related outcomes.
• To inform future research and clinical practice for SE-ED.

Main Methods:

• A systematic search was conducted for quantitative treatment studies on adult participants with SE-ED, with no restriction on eating disorder type.
• 2,938 studies were initially screened, leading to the inclusion of 23 studies in the final analysis.
• Included studies comprised randomized controlled trials, open-label studies, naturalistic follow-up studies, case series, case studies, and a pilot study, with generally low methodological quality.

Main Results:

• Inpatient treatment programs demonstrated short-term symptom reduction, but long-term outcomes were inconsistent.
• Outpatient and day-hospital programs showed promise for symptom reduction.
• Pharmacological interventions offered benefits, particularly as adjuvant therapies, and brain stimulation improved depressive symptoms, while other treatments yielded mixed results.

Conclusions:

• This is the first systematic review to comprehensively examine studied treatment interventions for SE-ED.
• Current evidence suggests potential benefits from inpatient, outpatient, and drug-based interventions, though long-term efficacy requires further investigation.
• The findings provide a foundation for developing improved research and clinical strategies for SE-ED management.