The overall effects of current psychological approaches to treating adults with anorexia nervosa were recently examined in a network meta-analysis by an international study that initially analyzed 14,003 trials, and then a final group of 13 comparative randomized clinical trials involving 1049 patients. The selected controlled trials compared psychological therapies with treatment as usual in adults receiving outpatient therapy for AN. The psychological interventions in the study included cognitive behavioral therapy (CBT), family-oriented treatments, psychodynamic treatments, a form of CBT targeting compulsive exercise, and cognitive remediation therapy followed by CBT. Other approaches during up to a year of follow-up included Maudsley AN treatment for adults (MANTRA), and specialist supportive clinical management (SSCM) (Lancet Psychiatry. 2021. 8:215).
The researchers found that some treatments had modest benefits for patients, but therapies currently recommended in the National Institute for Clinical Excellence (NICE) guidelines, and included in international treatment guides, did not differ significantly from expert treatment as usual in terms of treatment retention, weight restoration, or change in other ED symptoms.
Dr. Andrea Cipriani, of the University of Oxford, lead author of the study, noted that the goal of the study was to highlight the “gaps in current evidence and the need for more and better research to psychological therapies for treating anorexia.” Dr. Cipriani added that because of the relatively low quality and quantity of data available, the results should be viewed as “exploratory” rather than as confirmation that psychological therapies currently available are ineffective for AN patients.
This is an important analysis that makes plain the magnitude of need for developing treatments for adults with AN.