Psychotherapy helps sustain anorexia

Therapeutic treatment helps to combat eating disorder

15/10/2013

Can psychotherapy really help with anorexia? German scientists have dealt with this question and have published their findings in the journal "The Lancet". After all, two-thirds of those affected were able to achieve a lasting effect through therapeutic work.

Worldwide, 0.5 to 1 percent of the population affected
More and more people suffer from the so-called "anorexia nervosa" (Anorexia nervosa), according to the Federal Center for Health Education (BzgA) are now affecting 0.5 to 1 percent of the world's population. In all cases, a significant loss of weight is caused by starvation, excessive physical activity or a combination of both. In some cases, appetite suppressants, laxatives or dehydrating medications are also used, but despite the heavy weight loss, those affected continue to feel "fat"..

Anorexia is one of the leading causes of death among girls and young women
Anorexia is the most prevalent in the age group 14-18 years, and more often in girls than in boys. The dramatic thing about this eating disorder: Anorexia is one of the leading causes of death among girls and young women, and about 20 percent of those affected fall victim to mental illness over time.

So far, no substantiated evidence of the effectiveness of psychotherapy
Accordingly, an anorexia requires urgent action. Since the disease is a mental disorder in the field of mental eating disorders, it is usually tried to help those affected with appropriate psychotherapy. So far, however, there was no sound scientific evidence as to whether such a therapy has a lasting effect or which form of therapy is most effective. But now a German research team has taken on the topic and carried out the world's largest study to date for the psychotherapeutic treatment of anorexic patients. Led by the Departments of Psychosomatic Medicine of the University Hospitals of Tübingen and Heidelberg, ten German hospitals participated in the study.

World's largest study on the psychotherapeutic treatment of anorexia
The researchers set themselves the goal of finding out whether therapies specifically tailored to anorexic patients have a more lasting effect than conventional therapy concepts. 242 adult women participated in the study, which were initially distributed by lot to three therapeutic groups. One group was treated with a "normal" psychotherapy, the other two with two newly developed procedures, which were considered particularly promising. The researchers monitored the women for a total of 22 months, ten months of therapy, and another 12 months of follow-up to see how the treatments had a lasting effect.

On the trail of the unconscious causes of anorexia
One of the so-called "cognitive behavioral therapies" was the psychotherapeutic concepts specially tailored to anorexics, during which the subjects were confronted with the consequences of their illnesses and learned to eat "normally", as the head of the University Hospital Tübingen, Stephan Zipfel, explained in an article in the journal "The Lancet". In the second case, the women were treated as part of "focal psychodynamic psychotherapy," which is a continuation of psychoanalysis. The focus was primarily on the hidden, sometimes unconscious causes of anorexia, in that "psychotherapist and patient [.] Get to the bottom of the inner conflicts and emotional triggers of the disease," continued Wolfgang Herzog, head of Heidelberg University Hospital.

Women take on average 3.8 kilos
The result of the study: In all three groups the women - who weighed an average of 46.5 kilos at the beginning of the study - gained an average of 3.8 kilos. Despite the overall success, according to Herzog, the two new concepts would nevertheless have shown advantages, because "Patients in the behavioral therapy group increased faster during the therapy. And: In the focal psychodynamic therapy, the symptoms improved after the end of therapy. The patients in this group had the best overall cure rates even one year after the treatment. "In addition, the scientists would find a clear difference with regard to the discontinuation rate - because while this was 41 percent in conventional therapy, the subjects in the group ended up with" focal psychodynamic psychotherapy "treatment in only 23 percent of cases prematurely.

High dropout rate requires improvement in therapy approaches
The overall result of the researchers: Two-thirds of the women carried out the therapy to the end, the other women terminated therapy and after-treatment prematurely. According to Cynthia Bulik of the University of North Carolina, the high drop-out rate is a fundamental problem in studies on anorexia, which is explained by the difficult treatability of the chronic disease. According to the scientists around Wolfgang Herzog, however, the results of the new study could help to treat anorexic women more effectively in the future: "Optimized treatment as usual, ie the combination of psychotherapy and structured care by a GP, should provide a solid basis for the outpatient Treating adult patients with anorexia nervosa. Focal psychodynamic therapy proved to be beneficial in terms of recovery during the 12-month follow-up, the improved form of cognitive-behavioral therapy was more effective in accelerating weight gain and reducing the psychopathology of the eating disorder the further adaptation and improvement of these novel therapeutic approaches ", the researchers continue. (No)

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