Page 26 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg

26 Chapter 2
ing individual psychological therapies with each other, no specific treatment is consistently superior to any other specific approach (Hay, Claudino, Touyz, & Elbaky, 2015).
Recent guidelines recommend that anorexia nervosa programs should focus on engaging the patient, on nutritional & physical rehabilitation in order to regain weight, and on provision of structured psychological treatment. In addition, treat- ment outcome should aim at supporting quality of life (QoL) changes, needed for improvement or recovery (NICE, 2017).
Although evidence is yet insufficient to support outpatient- versus inpatient programs, the treatment of anorexia nervosa has moved clinically from long-term inpatient programs with outpatient follow-up, to a more common model of individual outpatient treatment with hospital backup (Hay, Claudino, Smith et al., 2015).
Methodologically robust studies are small in number and inconclusive, meaning that conflicting results are common in anorexia nervosa literature (Hay et al., 2014). In less recent randomized controlled trials (RCTs), sample sizes were inappropriate small, treatment outcomes were addressed in varied ways and different treatments were employed within the same setting (Fairburn, 2005).
With the increase of recent RCTs run with newly developed psychological treat- ments and significantly larger sample sizes (Byrne et al., 2017), examining the effects by conducting an up-to-date meta-analysis including the most recent studies, is sensi- ble. This meta-analysis, in contrast to other recent meta-analyses (Murray, Quintana, Loeb, Griffiths, & Le Grange, 2018; Zeeck et al., 2018) includes end-of -treatment outcome measures on weight gain, eating disorder pathology and on QoL. In addi- tion, this study includes a 2017 large RCT (Byrne, 2017). Whereas other meta-analyses
included RCTs on various non-psychological treatment modalities (Murray et al., 2018), or studies comparing two psychological treatment conditions (Zeeck et al., 2018), this study examines the effects of psychological treatments versus a control condition for patients with anorexia nervosa from 12 years and older. This present study provides an up-to-date overview and is an addition to the available body of evidence regarding psychological treatment for anorexia nervosa.