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Special Section Article
Anorexia nervosa treatment: A systematic review of randomized controlled trials†
Article first published online: 16 MAR 2007
Copyright © 2007 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 40, Issue 4, pages 310–320, May 2007
How to Cite
Bulik, C. M., Berkman, N. D., Brownley, K. A., Sedway, J. A. and Lohr, K. N. (2007), Anorexia nervosa treatment: A systematic review of randomized controlled trials. Int. J. Eat. Disord., 40: 310–320. doi: 10.1002/eat.20367
- Issue published online: 28 MAR 2007
- Article first published online: 16 MAR 2007
- Agency for Healthcare Research and Quality. Grant Number: 290-02-0016
- anorexia nervosa;
- clinical trials;
- evidence-based review;
- eating disorders;
- cognitive behavioral therapy;
- family therapy
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), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics.
We searched six major databases for studies on the treatment of AN from 1980 to September 2005, in all languages against a priori inclusion/exclusion criteria focusing on eating, psychiatric or psychological, or biomarker outcomes.
Thirty-two treatment studies involved only medications, only behavioral interventions, and medication plus behavioral interventions for adults or adolescents. The literature on medication treatments and behavioral treatments for adults with AN is sparse and inconclusive. Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration, although its efficacy in the underweight state remains unknown. Variants of family therapy are efficacious in adolescents, but not in adults.
Evidence for AN treatment is weak; evidence for treatment-related harms and factors associated with efficacy of treatment are weak; and evidence for differential outcome by sociodemographic factors is nonexistent. Attention to sample size and statistical power, standardization of outcome measures, retention of patients in clinical trials, and developmental differences in treatment appropriateness and outcome is required. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007