Page 155 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg

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and a binge eating disorder and separately for patients with anorexia nervosa and Part III examines psychological and behavioral factors associated with clinical outcome of weight loss surgery.
Part I
Treatment of anorexia nervosa
The efficacy of specialized psychological treatments for anorexia nervosa
For anorexia nervosa, the eating disorder most difficult to treat, only a limited number of specialized psychological treatments are available, and findings with regard to their efficacy are inconclusive. Evidence is lacking for prioritizing one specialized psychological treatment over the other (Hay, Claudino, Touyz, & Abd Elbaky, 2015). Furthermore, evidence for prioritizing specialized over non-specialized, control treatments, regularly offered in routine practice (Zeeck et al., 2018; Murray, Quintana, Loeb, Griffiths, & Le Grange, 2019), is lacking.
As there has recently been an increase of high-quality randomized controlled trials, run with newly developed psychological treatments, conducting a meta-analysis to examine whether the evidence base for specialized psychological treatments can be broadened was relevant. In Chapter 2, by conducting a meta-analysis, we syste- matically assess whether specialized treatments for anorexia nervosa are superior to non-specialized, control treatments.
We hypothesized that differences in treatment effect would be found in favor of specialized psychological treatments, on either the outcome measure ‘weight regain’ and/or on the outcome measure ‘improvement of eating disorder psychopathology’, or on the outcome measure ‘improvement of quality of life’.
Main findings
The meta-analyses indicated that no differences between psychological treat- ments and control conditions could be established on weight gain, on eating disorder pathology or on quality of life. Our findings may also suggest that recently developed, recommended psychological treatments for anorexia nervosa lack sufficient strength for added value to be detected compared with control conditions. Our findings suggest that studies including patients over 18 years were more effective on weight gain than studies including younger patients. In high-quality studies and in studies in which therapist training was reported, larger effects were found on both weight gain and on quality of life, compared to low quality studies and studies without reported