Effective interventions for adolescents with anorexia nervosa

Abstract

Background: Anorexia Nervosa (AN) is a serious psychiatric illness with both psychological and medical sequelae that usually onsets during adolescence. The illness presents formidable challenges to clinicians. Despite these facts, there are few treatments studies for the adolescent age group.

Aims: This report provides a critical review of the most common treatments and the empirical support for them for adolescent AN.

Method: Clinical and research literature was reviewed to identify empirically supported treatments with an emphasis on identifying pertinent randomized controlled trials. However, relevant clinically oriented reports and consensus clinical guidelines were also included when other systematic research was unavailable in order to provide a more comprehensive view of current treatment strategies for adolescents with AN.

Results: There are only five randomized clinical trials specifically addressing treatment for adolescent AN. Only 207 subjects were enrolled in these studies with an average cell size of about 20 subjects. Data from these trials suggest that family therapy wherein parents re-feed their adolescent offspring is effective for AN in this age group. However, other treatment approaches (e.g. individual therapy, group therapy, hospitalization, medication) have not been sufficiently or systematically studied.

Conclusions: Family therapy based on parental re-feeding is an effective approach for adolescent AN. However, the superiority of family therapy over other types of interventions has not been sufficiently demonstrated. There is an urgent need to conduct treatment research in this area to guide clinical care for this vulnerable population.

Declaration of interest: Dr Lock is supported by NIH Grant R01MH070621-01.

Keywords:

• Anorexia nervosa
• adolescent
• eating disorders
• treatment
• review