Evidence-Based Treatment

Your Children Deserve Better Treatment For Anorexia Nervosa And Bulimia Nervosa...

What Can You Do About It?

Many treatments for anorexia nervosa (AN) and bulimia nervosa (BN) that are used today are based on hypotheses about what causes people to have an eating disorder (ED). It is not known whether or not these hypotheses are true. Often there is little or no research that establishes scientific proof for these theories. Moreover, little has been done in terms of proving that such therapies really work in treating AN and BN.

Why Is Understanding The Etiology Of Anorexia Nervosa And Bulimia Nervosa Important?

Until we understand what actually causes a disorder, treatments tend to be aimed at reducing symptoms. This can be a reasonable strategy, provided that we test to ensure that such symptom reduction treatment actually works, and changes the course of the illness. Once the cause of an illness is understood, then specific therapies can be designed to prevent or cure the disease.

One proven strategy is to develop more specific treatments based on the best available knowledge about these disorders. Most critically, the effectiveness of these treatments must be proven. In order to do this, design rigorous trials must show that these therapies actually make a difference as compared to the natural course of the illness.

Several Important Issues Should Be Noted In Considering Recommendations For Treatment:

  • None of these treatments are a “cure.” They reduce symptoms and provide better coping strategies.
  • Some treatments have more proof of being effective, or work better than other treatments. Several recent publications in the United States and England have reviewed various types of treatment for AN and BN and made recommendations. These recommendations come from the America Psychiatric Association (APA) in the US: (http://www.psych.org/psych_pract/treatg/pg/prac_guide.cfm) and National Institute for Health and Clinical Excellence (NICE) in England: (http://www.nice.org.uk/guidance/CG9/niceguidance/pdf/English)
  • Who is delivering the treatment?
  • Has the therapist been trained in the specific therapy by an expert?
  • Does the therapist have ongoing expert consultation and supervision?
  • Does the therapist have an advanced degree in some aspect of mental health care from an accredited university?

We Have 2 Missions At UCSD:

  • Deliver the best possible therapies available today with therapists who have expert training and supervision, and advanced degrees
  • Be a leader in developing the new therapies for tomorrow. Most of the current therapies for AN and BN were initially designed to treat other disorders. They are not specific for the unique symptoms of AN and BN. For example, the ascetic temperament, resistance to treatment, lack of insight, and disinterest in rewards other than weight loss that are characteristic of AN.

At UCSD, under the leadership of Dr. Walter Kaye, and in collaboration with leading universities, we are at the forefront of research aimed at understanding the causes of ED and new treatment applications. Most importantly, we apply new findings in the clinic. For example, new medications for AN and BN. Other new psychotherapies are now being designed to better address obsessional symptoms, or traits such as impaired set shifting, or central coherence (paying attention to details rather than the big picture).