Psychotherapy helps with anorexia

Therapeutic treatment helps fight eating disorders

Can Psychotherapy Really Help With Anorexia? German scientists have dealt with this question and have now published their results in the specialist journal “The Lancet”. According to this, therapeutic work was able to achieve a lasting effect in two thirds of those affected.

0.5 to 1 percent of the population affected worldwide More and more people suffer from the so-called "anorexia" (anorexia nervosa), according to the Federal Center for Health Education (BzgA), 0.5 to 1 percent of the population worldwide is now affected. Characteristic in all cases is a strong weight loss, which those affected bring about through hunger, excessive sporting activity or a combination of both. In some cases, appetite suppressants, laxatives or dehydrating drugs are also used, but despite the strong weight loss, those affected still feel "fat".

Anorexia is one of the most common causes of death in girls and young women. Anorexia is most common in the age group of 14 to 18 years, and also far more common in girls than in boys. The dramatic thing about this eating disorder: Anorexia is one of the most common causes of death in girls and young women, about 20 percent of those affected fall victim to the mental illness over time.

So far, no substantiated evidence about the effectiveness of psychotherapy. Accordingly, there is an urgent need for action in anorexia nervosa. Since the disease is a mental disorder in the field of psychological eating disorders, attempts are usually made to help those affected with appropriate psychotherapy. So far, however, there has been no sound scientific evidence as to whether such therapy has a lasting effect or which form of therapy is most effective. But now a German team of researchers has taken on the topic and carried out the largest study worldwide on the psychotherapeutic treatment of anorexics. Led by the departments for psychosomatic medicine at the university clinics in Tübingen and Heidelberg, a total of ten German clinics participated in the study.

World's largest study on the psychotherapeutic treatment of anorexics The goal of the researchers was to find out whether therapies tailored to anorexia nervosa have a more sustainable effect than conventional therapy concepts. 242 adult women participated in the study, which were initially divided into three therapeutic groups by lot. One group was treated with "normal" psychotherapy, the other two with two newly developed procedures that were considered particularly promising. The scientists observed the women for a total of 22 months, ten months of therapy and a further 12 months of follow-up, in which the extent to which the treatments had a lasting effect was examined.

On the trail of the unconscious causes of anorexia nervosa The psychotherapeutic concepts specially tailored to anorexia nervosa were so-called "cognitive behavioral therapy", in the course of which the test subjects were confronted with the consequences of their illness and learned "normal" eating behavior, as explained by the head of the University Hospital Tübingen, Stephan Zipfel, in an article in the specialist magazine “The Lancet”. In the second case, the women were treated as part of a "focal psychodynamic psychotherapy", which represents a continuation of psychoanalysis. The focus was primarily on the hidden, sometimes unconscious, causes of anorexia nervosa by “psychotherapist and patient [.] Get to the bottom of internal conflicts and emotional triggers of the disease”, said the head of the Heidelberg University Hospital Wolfgang Herzog .

Women gain an average of 3.8 kilos The result of the study: In all three groups, the women - who had weighed an average of 46.5 kilos at the start of the study - gained an average of 3.8 kilos. Despite the overarching success, according to Herzog, the two new concepts would have shown advantages, because “Patients in the behavioral therapy group increased faster during therapy. And: With focus psychodynamic therapy, the symptoms improved even after the end of therapy. The patients in this group had the lowest overall healing rates even one year after treatment. ” In addition, the scientists would find a clear difference in terms of the dropout rate - because while this was 41 percent with conventional therapy, the subjects in the group ended the treatment early with "focal psychodynamic psychotherapy" in 23 percent of the cases.

High dropout rate requires improvement of therapy approaches The overall result of the researchers: Two thirds of the women carried out the therapy to the end, the other women ended the therapy and follow-up treatment prematurely. According to Cynthia Bulik from the University of North Carolina, the high dropout rate should be seen as a fundamental problem in studies on anorexia nervosa, which can be explained by the difficulty in treating the chronic disease. However, according to the scientists led by Wolfgang Herzog, the results of the new study could help to treat anorexic women more effectively in the future: “Optimized treatment as usual, ie the combination of psychotherapy and structured care by a family doctor, should provide a solid basis for the outpatient Treatment of adult patients with anorexia nervosa can be considered. Focal psychodynamic therapy was beneficial in terms of recovery during the 12-month follow-up, and the improved form of cognitive-behavioral therapy was more effective in accelerating weight gain and reducing the psychopathology of the eating disorder. "Accordingly," Long-term results could be helpful for the further adaptation and improvement of these new therapeutic approaches, ”the researchers continued. (No)

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