A trial has been held for the first time to measure the effects of psychotherapy on women with anorexia nervosa, considered to be one of the most fatal mental disorders, in a study called the Anorexia Nervosa Treatment of OutPatients (ANTOP). Researchers hailed from ten different German university eating disorder centers. Until now, there have been no large-scale clinical trials to measure the efficacy of different therapeutic methods on people who suffer from anorexia.

The study found that women whose anorexia isn’t too severe made significant progress in treatment on an out-patient basis, and continued to make strides even after their therapy was finished. Anorexia is characterized by emaciation, the intense fear of weight gain, poor self-esteem, and often depression as well as lack of menstruation in women. One percent of the population has anorexia nervosa. It's a disorder that distorts the perception of one’s body image and weight, and may also be linked to binge-eating, anxiety and other compulsive behaviors. Over long periods of time during which people with anorexia starve themselves, they can develop more serious symptoms, including the thinning of bones and hair, dry skin, mild anemia, low blood pressure, lethargy, brain damage and multiorgan failure, according to the National Institute of Mental Health.

“In the long-term course, in up to 20 percent of the cases, anorexia leads to death, making it the most lethal of all of the mental disorders,” Professor Stephan Zipfel, an author of the study, said in a press release. “Patients with anorexia often suffer from the psychological or physical consequences of the disease their entire lives.”

The ANTOP studied followed 242 adult women within a period of 22 months – 10 months were devoted to therapy, and the following 12 months were for observation. The participants were divided into three groups of around 80 each, and each group was treated with a different psychotherapy method to see which one was most effective. The women attended once-a-week therapy sessions over a period of ten months.

The first type of psychotherapy method tested was focal psychodynamic therapy, which addresses the impact of negative relationships on the way the patient processes emotions. Cognitive behavior therapy, on the other hand, focused on normalizing eating behaviors and weight gain, and then worked on problems that were linked to the eating disorder, which includes social skills and problem-solving. Finally, standard psychotherapy was the third type of treatment used – a form of therapy that is the most commonly used in anorexia treatment, where the patients selected their psychotherapists themselves.

The researchers found that the two new types of treatment “demonstrated advantages compared to the [standard] optimized therapy as usual,” Professor Zipfel said in the press release. Participants in all three groups were found to have made significant weight gains both at the end of their therapy and after 12 months following. And it was focal psychodynamic therapy that seemed to be the most successful, though the specific cognitive behavior therapy led to an increased amount of weight gain. There are various other types of psychotherapy that have been used to treat people with anorexia, although limited information was available on which are most effective until this study was completed.

 

Source: Stephan Zipfel, Beate Wild, Gaby Groß, Hans-Christoph Friederich, Martin Teufel, Dieter Schellberg, Katrin E Giel, Martina de Zwaan, Andreas Dinkel, Stephan Herpertz, Markus Burgmer, Bernd Löwe, Sefik Tagay, Jörn von Wietersheim, Almut Zeeck, Carmen Schade-Brittinger, Henning Schauenburg, Wolfgang Herzog. Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trialThe Lancet, 2013.