The diagnosis and treatment of eating disorders.

About this resource

BACKGROUND: Eating disorders are of major significance both in clinical medicine and in society at large. Anorexia and bulimia nervosa almost exclusively afflict young persons, severely impairing their physical and mental health. The peak ages for these diseases are in late adolescence and young adulthood; patients therefore suffer setbacks both in school and/or in their occupational careers. This scientifically based S3 guideline was developed with the intention of improving the treatment of eating disorders and motivating future research in this area.

METHODS: The existing national and international guidelines on the three types of eating disorders were synoptically compared, the literature on the subject was systematically searched, and meta-analyses on bulimia nervosa and binge-eating disorder were carried out. 15 consensus conferences were held, as a result of which 44 evidence-based recommendations were issued.

RESULTS: Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Psychotherapy is the mainstay of treatment for all three disorders, and cognitive behavioral therapy is the form of psychotherapy best supported by the available evidence. The administration of selective serotonin reuptake inhibitors (SSRI) can be recommended as a flanking measure in the treatment of bulimia nervosa only. The evidence does not support any type of pharmacotherapy for anorexia nervosa or binge-eating disorder. Bulimia nervosa and binge-eating disorder can usually be treated on an outpatient basis, as long as they are no more than moderately severe; full-fledged anorexia nervosa is generally an indication for in-hospital treatment.

CONCLUSION: This guideline contains evidence- and consensus-based recommendations for the diagnosis and treatment of eating disorders. If strictly implemented, it should result in improved care for the affected patients.

AuthorHerpertz, Stephan; Hagenah, Ulrich; Vocks, Silja; von Wietersheim, Jorn; Cuntz
JournalDeutsches Arzteblatt International
Volume108(40):678-85
Year2011

See also

An Eating Disorders Resource for Schools: A Manual to Promote Early Intervention and Prevention of Eating Disorders in Schools

This manual informs teachers, coaches, and members of the school community about the prevention and early intervention of Eating Disorders.

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QuEDS Guide to Admission and Inpatient Treatment

The Guide to Admission and Inpatient Treatment has been developed by the Queensland Eating Disorder Service (QuEDS) and is supported by current literature, research, and expert opinion.

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National Athletic Trainers' Association Position Statement: Preventing, detecting, and managing disordered eating in athletes

OBJECTIVE: To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes.

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Early detection of eating disorders in general practice

The aim of this article was to heighten awareness of the role of early identification and diagnosis of eating disorders, especially anorexia nervosa and bulimia nervosa, in the primary care setting.

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