Effectiveness of non-pharmacological interventions on individuals with anorexia nervosa: A systematic review and meta-analysis

Gan, Javeil Ke En; Wu, Vivien Xi; Chow, Gigi; Chan, Janice Kuang Yeung; Klainin‐Yobas, Piyanee

doi:10.1016/j.pec.2021.05.031

Cited by 12 publications

(7 citation statements)

References 47 publications

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“…A meta-analysis including 19 RCTs synthesised the best available evidence of non-pharmacological face-to-face interventions on BMI, body dissatisfaction, depression and anxiety among AN individuals [ 94 ]. Behavioural family system therapy (BFST) was found to be more effective than ego-oriented individual therapy in enhancing BMI, and conjoint family therapy (CFT) more effective than separated family therapy in reducing depression, with combined family and individual therapy producing larger effect sizes than individual therapy alone [ 94 ]. Conversely, results from RCTs consider FBT and adolescent-focused individual therapy (AFT) to be equally beneficial in terms of clinical outcomes relating to weight gain, reduction of ED behaviours, and depressive symptomatology [ 94 , 130 ].…”

Section: Resultsmentioning

confidence: 99%

Psychotherapies for eating disorders: findings from a rapid review

Russell,

Aouad,

et al. 2023

J Eat Disord

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Background Psychotherapy is considered central to the effective treatment of eating disorders—focusing on behavioural, psychological, and social factors that contribute to the illness. Research indicates psychotherapeutic interventions out-perform placebo, waitlist, and/or other treatments; but, outcomes vary with room for major improvement. Thus, this review aims to (1) establish and consolidate knowledge on efficacious eating disorder psychotherapies; (2) highlight select emerging psychotherapeutic interventions; and (3) identify knowledge gaps to better inform future treatment research and development. Methods The current review forms part of a series of Rapid Reviews published in a special issue in the Journal of Eating Disorders to inform the development of the Australian-government-funded National Eating Disorder Research and Translation Strategy 2021–2031. Three databases were searched for studies published between 2009 and 2023, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, and population studies). Data pertaining to psychotherapies for eating disorders were synthesised and outlined in the current paper. Results 281 studies met inclusion criteria. Behavioural therapies were most commonly studied, with cognitive-behavioural and family-based therapies being the most researched; and thus, having the largest evidence-base for treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Other therapies, such as interpersonal and dialectical behaviour therapies also demonstrated positive treatment outcomes. Emerging evidence supports specific use of Acceptance and Commitment; Integrative Cognitive Affective; Exposure; Mindfulness; and Emotionally-Focused therapies; however further research is needed to determine their efficacy. Similarly, growing support for self-help, group, and computer/internet-based therapeutic modalities was noted. Psychotherapies for avoidant/restrictive food intake disorder; other, and unspecified feeding and eating disorders were lacking evidence. Conclusions Currently, clinical practice is largely supported by research indicating that behavioural and cognitive-behavioural psychotherapies are most effective for the treatment of eating disorders. However, the efficacy of psychotherapeutic interventions varies across studies, highlighting the need for investment and expansion of research into enhanced variants and novel psychotherapies to improve illness outcomes. There is also a pressing need for investigation into the whole range of eating disorder presentations and populations, to determine the most effective interventions.

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Section: Resultsmentioning

confidence: 99%

Psychotherapies for eating disorders: findings from a rapid review

Russell,

Aouad,

et al. 2023

J Eat Disord

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“…Olanzapine alone might be insufficient in the treatment of AN. An improved BMI is important in AN patients; cognitive remediation therapy (CRT), family therapy, and other nonpharmacological interventions also play important roles in the treatment of AN (Attia & Walsh, 2009 ; Fisher et al, 2018 ; Gan et al, 2021 ; Tchanturia et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of olanzapine in the treatment of anorexia nervosa: A systematic review and meta‐analysis

2022

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Objective: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by starvation and malnutrition, a high incidence of coexisting psychiatric conditions, and treatment resistance. The effect of pharmacotherapy has been controversial. Method:A systematic review was conducted for evidence of an effect of olanzapine versus placebo in adults or its effect as adjuvant treatment of AN in adolescents.Results: A total of seven articles (304 patients with AN) were identified. There were four double-blind, randomized studies examining the effect of olanzapine in the treatment of AN. The mean difference in body mass index (BMI) at the end of treatment between olanzapine and placebo was 0.67 kg/m 2 (95% confidence interval (CI) 0.15-1.18 kg/m 2 ; p = 0.01; I 2 = 0%, p for heterogeneity < 0.79). The olanzapine groups showed a significant increase in BMI of 0.68 kg/m 2 (95% CI 0.22-1.13 kg/m 2 ; p < 0.001; I 2 = 0%, p for heterogeneity = 0.74) compared to the placebo groups. Only two studies examined the effect of olanzapine as adjuvant treatment in adolescents and showed an increase in BMI of 0.66 kg/m 2 (95% CI −0.36 to 1.67 kg/m 2 ; p = 0.21; I 2 = 11%, p for heterogeneity = 0.32).

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“…Therefore, we suppose that in future studies it would be important to address the association between personal network size and the severity of anorexia outcomes for women with this condition. This could extend understanding of whether interventions tailored toward the improvement of the general social skills of young women ( Spence, 2003 ) are also effective in the prevention of severe anorexia symptoms ( Pratt and Woolfenden, 2002 ; Dimitropoulos et al, 2016 ; Hay et al, 2019 ; Gan et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Anorexia and Young Womens’ Personal Networks: Size, Structure, and Kinship

Mikhaylova

Dokuka

2022

Front. Psychol.

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Anorexia is a serious threat to young women’s wellbeing worldwide. The effectiveness of mental health intervention and treatment is often evaluated on the basis of changes in the personal networks; however, the development of such measures for young women with anorexia is constrained due to the lack of quantitative descriptions of their social networks. We aim to fill this substantial gap. In this paper, we identify the basic properties of these women’s personal networks such as size, structure, and proportion of kin connections. The empirical analysis, using a concentric circles methodology, is based on 50 ego networks constructed on data drawn from interviews with Russian-speaking bloggers who have been diagnosed with anorexia and write about this condition. We conclude that young women with anorexia tend to support a limited number of social ties; they are prone to select women as alters, but do not have a preference to connect to their relatives. Further research is needed to elucidate whether these personal network characteristics are similar among women with anorexia who belong to different age, ethnic, cultural, and income groups.

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Effectiveness of non-pharmacological interventions on individuals with anorexia nervosa: A systematic review and meta-analysis

Cited by 12 publications

References 47 publications

Psychotherapies for eating disorders: findings from a rapid review

Psychotherapies for eating disorders: findings from a rapid review

Effectiveness of olanzapine in the treatment of anorexia nervosa: A systematic review and meta‐analysis

Anorexia and Young Womens’ Personal Networks: Size, Structure, and Kinship

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