Inpatient treatment of anorexia nervosa: some research-guided changes

Over a period of more than 15 years, our approach to the inpatient treatment of anorexia nervosa has changed considerably. Three major steps may be distinguished in this evolution. Until 1974, weight restoration was induced by a medical regime, and most patients had to stay in a psychotherapeutic community for several months. Between 1974 and 1980, different types of behavior therapy have been tried and compared ending up in a standardized behavioral contract system that is still used now. However, a large follow-up study forced us to question the second psychotherapeutic phase of the program and the long stay in the hospital. Moreover, the increasing number of patients made it practically impossible to treat them all individually. For these reasons, from 1982, an intensive multifaceted group approach was developed, the major components of which are described. It is concluded that continuing research from a scientist-practitioner's viewpoint is the best guide for a fruitful trial-and-error process in the therapeutic approach to patients with eating disorders.