New Treatment Achieves 75% Remission in Eating Disorders

Laurie Barclay, MD

July 08, 2002

July 8, 2002 -- Conditioning methods and focusing on physical symptoms rather than on psychological problems may be most effective in eating disorders, according to a report in the July 9 issue of the Proceedings of the National Academy of Science. Remission rates were about 75% for patients with either anorexia or bulimia nervosa.

"Evidence for the effectiveness of existing treatments of patients with eating disorders is weak," write Cecilia Bergh, from Karolinska Institute in Sweden, and colleagues. "Relapse is considered a major problem in patients who have been treated to remission."

In a controlled trial of 32 patients (19 patients with anorexia and 13 with bulimia), 16 patients randomly selected to receive no treatment, and the remaining 16 were trained to eat and recognize satiety using computer support. They were also restricted from physical activity and rested in a warm room after meals.

After a median of 14.4 months (range, 4.9-26.5 months), 14 patients receiving the treatment and one patient still awaiting treatment went into remission, defined as normal body weight, cessation of binge eating and purging, normal psychiatric profile, normal laboratory studies, normal eating behavior and resumption of social activities.

Encouraged by these results, the authors enrolled 168 patients in their treatment program. Estimated remission rate was 75% and estimated time to remission was 14.7 months. Of 83 patients who were treated to remission, six patients (7%) relapsed, but 77 patients (93%) were still in remission at 12 months.

"Because the risk of relapse is maximal in the first year after remission, we suggest that most patients treated with this method recover," the authors write, acknowledging the need for a randomized controlled trial comparing this method with the standard of care for eating disorders. "The estimated cost of the present method is considerably below that of other methods."

Proc Natl Acad Sci USA. 2002;99(14):9486-9491

Reviewed by Gary D. Vogin, MD

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