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No Effective Medications for Anorexia Nervosa

Press Release Date: April 17, 2006

No medications are available that effectively treat patients suffering from anorexia nervosa, but a few behavioral therapies may help prevent a relapse and offer other limited benefits, according to a new review of currently available research on eating disorders released today by HHS' Agency for Healthcare Research and Quality.

Eating disorders are psychiatric illnesses with serious, potentially life-threatening medical consequences. Anorexia nervosa is characterized by an obsession with weight, severely restrained eating, sometimes exercising excessively, and an inability to maintain a healthy body weight.

This review of the scientific literature published since 1980 was conducted by AHRQ's Evidence-based Practice Center at RTI International and the University of North Carolina at Chapel Hill. It did not find any medications effective in treating anorexia nervosa but did find several behavioral therapies that appear to offer limited help. Cognitive behavioral therapy (CBT), a form of psychotherapy that encourages patients to develop thinking patterns that will counteract their unhealthy eating behavior, helped prevent relapse in adult anorexic patients once their weight had been restored to a normal level. There was not enough evidence to determine whether CBT works during the acute phase of the illness, before a patient with anorexia nervosa has been restored to a normal weight.

The researchers concluded that family therapy does not appear to work with adults with longstanding anorexia nervosa. One study found that family therapy worked better for younger patients than for older, more chronic patients. One particular kind of family therapy, which starts by encouraging parents to oversee a young person's nutrition, appeared to help these patients gain weight and make psychological improvements.

"These findings underscore the need to learn more about the causes of these frightening and poorly understood illnesses and to find effective treatments," said AHRQ Director Carolyn M. Clancy, M.D. "In the meantime, we need to make sure that clinicians use the evidence we currently have to help those suffering from eating disorders."

The review concludes that more research is needed to determine the best strategies for combining medication and behavioral therapy, possible harms of treatment, and whether treatments should be tailored to a patient's age, sex, gender, or other personal characteristics.

Anorexia nervosa has particularly devastating medical and psychological consequences that can persist even after recovery. If it begins in the teenage years, it can interfere with normal adolescent development. Patients with anorexia nervosa often suffer as well from emotional problems such as depression, anxiety, social withdrawal, heightened self-consciousness, and fatigue. Treatment of anorexia nervosa is also quite costly, as the more serious cases often require hospitalization in specialized facilities.

Funded by the Office of Research on Women's Health at the National Institutes of Health and the Health Resources and Services Administration's Office of Women's Health, the report was requested by the American Psychiatric Association and the Laureate Psychiatric Clinic and Hospital on behalf of an expert working group on eating disorders.

"The AHRQ report provides valuable information about the studies that have been done on treating eating disorders," said Vivian W. Pinn, M.D., Director of the NIH Office of Research on Women's Health. "It also highlights research needs in this area and will help inform a future research agenda."

Agency for Healthcare Research and Quality, United States Department of Health & Human Services

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