Q & A: Is Mandometer Treatment Worthwhile?

Reprinted from Eating Disorders Review
May/June 2012 Volume 23, Number 3
©2012 Gürze Books

Q: One of my patients with anorexia nervosa (AN) recently asked me about a “Mandometer Treatment” she’d read about on the Internet. Can you tell me what this is and what evidence exists for its value? (C.B., San Francisco, CA)

A: Mandometer treatment, an approach that gained some notoriety starting in the 1990s, focuses on providing patients with a balanced meal intake, in addition to which physical exercise is limited, patients’ food needs are calculated on a computerized interactive scale, and patients are “heated up” after meals, usually with heated jackets or blankets. This somewhat expensive treatment has been commercialized and franchised to several centers outside of Scandinavia, where it originated. On March 31, 2011, the FDA cleared Mandometer for the treatment of patients with eating disorders.

A recent uncontrolled study in the Netherlands compared 24 patients with anorexia nervosa receiving Mandometer treatment to 45 receiving treatment as usual. Although the assignment to treatment wasn’t random, the patients in each group were highly clinically comparable. Outcomes at 2 years showed no benefit for Mandometer treatment, and in fact a higher percentage of those receiving Mandometer treatment still required ongoing care at that point (IJED 2012;45: 193). The bottom line appears to be that the alleged superiority of Mandometer treatment is still lacking solid evidence from well-controlled research. If, indeed, a subgroup of patients exists that might ultimately receive greater treatment benefits from this approach over ordinary treatment, that subgroup has yet to be identified or defined.

— JY

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