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

RANZCP clinical practice guidelines for the treatment of eating disorders (2014)

Objectives: This clinical practice guidelines for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014.

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Fitness Australia Guidelines: Identifying and managing members with eating disorders and/or problems with excessive exercise.

These guidelines are designed to assist fitness centre staff to provide advice and support to the individual with an Eating Disorder or exercise problem and to manage facility use in this population to promote safety and well-being.

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Eating Disorders Toolkit: A practice-based guide to the inpatient management of adolescents with eating disorders, with special reference to regional and rural areas

Executive Summary: It is well recognised that early, timely and appropriate care will improve the likelihood of positive treatment outcomes for young people with an eating disorder.

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