Eating disorders 2

Question 1

what is the affiliation hypothesis with treatments?

Answer 1

clinicians go for their favourite treatment, only 35% report using the strongest therapy, lots of unevidenced based treatments

Question 2

the most successful interventions focus on what?

Answer 2

maintenance factors

safety behaviours, cognitive patterns, emotional patterns, social maintenance, family accommodation, nutrition

Question 3

2 studies implemented psychoeducation about dieting and disorders at ages 11-14. what was the result in both cases?

Answer 3

level of pathology got worse with Baronowski’s study in the short term and pathology worse in the long term for Carters study

Question 4

what are the 3 equally effective treatments for adults with anorexia?

Answer 4

40 sessions of individual CBT-ED, 20-30 sessions of MANTRA, 20-30 sessions of SSCM
(all similar level of effectiveness to behaviour therapy and all involve changing eating behaviour)

Question 5

AN-focused family therapy was most effective for children/adolescents with anorexia. What does this therapy involve?

Answer 5

non blaming, family starts by taking control of the childs eating then moves to giving control back and finishes with relapse prevention. helps give the parents initial control and get the child to eat

Question 6

what is the effective treatment for adults/adolescents with binge eating disorder?

Answer 6

16-20 sessions of group of individual CBT

Question 7

what is the effective treatment for adults with bulimia?

Answer 7

16-20 sessions of individual CBT (guided self help CBT first)

Question 8

what is the effective treatment for children/adolescents with bulimia?

Answer 8

family therapy for BN, CBT as a second line therapy

Question 9

what treatments are advised for atypical cases?

Answer 9

use the therapy recommended for the most similar full syndrome e.g. atypical BN use CBT-ED

Question 10

what is the key element to treatment and why?

Answer 10

start with FOOD

nutrition/exposure to foods has physical, cognitive, emotional benefits that helps eliminate fear and allow the person to think straighter

Question 11

when is it best to use in and day patients (intensive treatment) for anorexia?

Answer 11

stage 1 in treatment to tarry weight gain and cognitive change prior to outpatient evidence based therapies

Question 12

what are some weak treatments that are no longer recommended?

Answer 12

SSRIs at high doses for bulimia
novel antipsychotics for anorexia
neuromodulation
leukotomy

Question 13

transcranial stimulation methods seem to reduce depression slightly but evidence yet that this works =

Answer 13

neuromodulation

Question 14

cutting fibres in frontal lobes to provide slight relief for chronic anorexia with extreme OCD =

Answer 14

leucotomy

Question 15

reduces impulsive behaviours in binge eating disorder and bulimia but little change in core pathology, limited evidence for anorexia = which therapy?

Answer 15

dialectical behaviour therapy (DBT)

Question 16

a therapy that works for bulimia but slower and less effective than CBT =

Answer 16

interpersonal therapy

Question 17

what therapy is effective for anorexia but needs replicating in other countries?

Answer 17

focused psychodynamic approaches (FIT)

Question 18

list the psychological therapies with little evidence so far

Answer 18

mentalisation based therapy
acceptance and commitment therapy
mindfulness based approaches
family therapies not eating focused

Question 19

how much does recovery rate drop by when therapy is not followed by the book?

Answer 19

from 50% to 15%

Question 20

what is the recovery rate for treating non-underweight cases compared to underweight cases?

Answer 20

50% = non underweight, 30% underweight

Question 21

what does CBT_ED focus on?

Answer 21

perfectionism
low self esteem
need for control

Question 22

why are treatments for obesity not very successful?

Answer 22

we live in a toxic environment!! obesity is stubborn

Question 23

what can we do about obesity?

Answer 23

keep trying due to huge health and quality of life costs
political and social changes (sugar tax)
lifestyle coaching

Question 24

what is currently the most effective long term route to weight loss?

Answer 24

bariatric surgery