Differences amongst eating disorder diagnoses should be considered in effective management

1. Amongst adolescents with anorexia nervosa (AN) and bulimia nervosa (BN), interventions involving family-based therapy outperformed active control groups.

2. In binge-eating disorder (BED), psychotherapy and lisdexamfetamine outperformed active control. 

Evidence Rating Level: 2 (Good)

Eating disorders typically peak during adolescent years and have significant mental and physical health impacts – which explains why effective treatment is of growing clinical interest. Currently, there is no umbrella review summarizing findings for eating disorders (ED) for all age groups. As a result, the objective of the present systematic review and meta-analysis was to summarize the efficacy of various treatment options for eating disorders across several age groups

Of 844 identified records, 59 were included in the present review from database inception to December 2020. Studies were included if they were randomized controlled trials (RCTs) which evaluated ED participants of any age in any intervention in comparison to an active or inactive control condition. Systematic reviews without meta-analysis were excluded. Quality of the evidence was assessed using A Measurement Tool for the Assessment of Multiple Systematic Reviews (AMSTAR-PLUS). Data reporting was done by standardizing and harmonizing effect sizes from the studies.

Results demonstrated that in adolescents with AN and BN, interventions involving family-based therapy outperformed active control groups. Furthermore, individual CBT had the broadest efficacy versus control in adults with BN. Additionally, in BED, psychotherapy and lisdexamfetamine outperformed active control, though medications have been shown to have only short-term efficacy. Despite these findings, the study was limited by not pooling individual randomized controlled trials in previous meta-analyses. Nonetheless, the present umbrella review supports the recommendations from most guidelines and extends support especially for cognitive behavioral therapy for EDs.

Click to read the study in Neuroscience & Biobehavioral Reviews

Image: PD

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