Randomized controlled trial of a treatment for anorexia and bulimia nervosa

Abstract

Evidence for the effectiveness of existing treatments of patients with eating disorders is weak. Here we describe and evaluate a method of treatment in a randomized controlled trial. Sixteen patients, randomly selected out of a group composed of 19 patients with anorexia nervosa and 13 with bulimia nervosa, were trained to eat and recognize satiety by using computer support. They rested in a warm room after eating, and their physical activity was restricted. The patients in the control group (n = 16) received no treatment. Remission was defined by normal body weight (anorexia), cessation of binge eating and purging (bulimia), a normal psychiatric profile, normal laboratory test values, normal eating behavior, and resumption of social activities. Fourteen patients went into remission after a median of 14.4 months (range 4.9-26.5) of treatment, but only one patient went into remission while waiting for treatment (P = 0.0057). Relapse is considered a major problem in patients who have been treated to remission. We therefore report results on a total of 168 patients who have entered our treatment program. The estimated rate of remission was 75%, and estimated time to remission was 14.7 months (quartile range 9.6 > or = 32). Six patients (7%) of 83 who were treated to remission relapsed, but the others (93%) have remained in remission for 12 months (quartile range 6-36). Because the risk of relapse is maximal in the first year after remission, we suggest that most patients treated with this method recover.

Figures

Figure 1

Kaplan–Meier plot of the number of patients in remission (%) in a group of 16 anorexic or bulimic patients who were treated and another group of 16 anorexic or bulimic patients who were waiting to be treated.

Figure 2

Kaplan–Meier plot of the number of eating disorder patients in remission (%) in a group of 168 patients.

Figure 3

Kaplan–Meier plot of the number of patients in remission (%) in a group of 85 patients with anorexia nervosa (AN), 38 patients with bulimia nervosa (BN), and 45 patients with an EDNOS.

Figure 4

Kaplan–Meier plot of the number of patients in remission (%) in a group of 83 patients treated to remission.