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Chapter 59. Treatment of Eating Disorders

W. Stewart Agras, M.D.
DOI: 10.1176/appi.books.9781585623860.435224

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Excerpt

Eating disorders are seen frequently in the clinic, reflecting a combined prevalence in women for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) of about 3.5% for the full disorder and 6% if subthreshold disorders are included (Hudson et al. 2007). Males are affected less frequently; about 10% of all cases of AN and BN are in males, with the proportion rising to about 30% for BED in clinical samples. Because much comorbid psychopathology is associated with each of these disorders, including current major depression in about 25% of cases, the treatment plan must take any such disorders into account. Two forms of treatment, psychopharmacological and psychotherapeutic, are effective in the treatment of BN and BED, and possibly in AN. Hence, determining how to sequence or combine treatment modalities is an important issue.

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FIGURE 59–1. Flow chart depicting different treatment sequences for bulimia nervosa (BN).CBT = cognitive-behavioral therapy.

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CME Activity

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Sample questions:
1.
A wide range of antidepressants have been found to be effective in treating bulimia nervosa (BN). Which of the following has been approved by the U.S. Food and Drug Administration (FDA) to treat this condition?
2.
When prescribing an antidepressant to treat bulimia nervosa (BN), psychiatrists should keep in mind which of the following clinical trial findings?
3.
Which of the following therapies has been shown to be superior to placebo in reducing binge eating and/or purging?
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