Crisp, A.H., Norton, Kingsley, Gowers, Simon, Halek, Christine, Bowyer, Carol, Yeldham, Denise, Levett, Gill, and Bhat, A.
Anorexia nervosa is an eating disorder that primarily affects young women; it is characterized by avoidance of eating and other measures designed to prevent weight gain. The condition can last a lifetime, which itself can be shortened by the disease; a number of anorectics eventually die of starvation or related complications. Research has demonstrated that in many cases, complete recovery is possible, but the most effective treatment method to restore proper weight in the short term has not been determined. Although the cause of this disorder is not clear, the authors contend that a fundamental feature is an irrational fear of growing into adulthood, which manifests itself in a refusal to reach adult body weight. Therapy might involve establishing eating patterns by means of nutritional counseling in addition to individual and family psychotherapeutic techniques. To evaluate the effectiveness of such an approach to treating anorexia nervosa, a study of 90 female anorectics was conducted. The patients were assigned to one of four treatment groups: (1) inpatient treatment; (2) outpatient treatment (both individual and family therapy) combined with dietary counseling; (3) outpatient group psychotherapy plus dietary counseling; or (4) no further treatment. The details of the approach to both patient and parents in therapeutic sessions are described. The intermediate results of the study after one year of follow-up are presented. In general, those in the first three groups fared better, except for one girl in group 3, who died. Weight gain at the end of one year was highest among those in group 3, although those in group 1 gained weight faster. Weight gain in these groups led to resumption of menstruation for many patients. (One of the consequences of anorexia is amenorrhea.) Methodological problems with the study, especially the necessity of having a 'no treatment' group, are discussed. Nevertheless, the authors feel that the results of the three interventions, at the end of one year, are promising. (Consumer Summary produced by Reliance Medical Information, Inc.)