Page 9 - Today's Dietitian (February 2020)

Health Matters

patients with refractory illness. In the
current study, approximately one-half
had undergone residential therapy, par-
tial hospitalization, or intensive outpa-
tient treatment, and two-thirds received
three or more types of psychological
treatment. More than 60% reportedly
received family-based treatment, which
is recognized as the most effective inter-
vention for adolescent anorexia nervosa.
“Anorexia nervosa is a complex
condition with the highest mortality
rate of any psychiatric disorder,”
Accurso says. “We know that families
are the most important resource in
recovery, which is why family-based
treatment is the gold standard for
adolescent anorexia nervosa.
“However, treatment doesn’t work
for everyone. Parents are telling us
that recovery needs to be approached
more holistically, with treatments that
extend beyond eating disorder symp-
toms to target emotional well-being,
cognitive flexibility, and establishment
of a meaningful life.”
The authors also noted that parents
are challenging the field’s definition of
recovery.
“Parents are schooling us on how it
should be defined,” says Accurso, who
Complete Recovery Remains is affiliated with the UCSF Weill Insti-
tute for Neurosciences. “We found that
Elusive to Anorexia Patients parents have a much broader view of
recovery, which included psychologi-
T hree in four patients with Program and an assistant professor living. Researchers are missing the
cal well-being and building a life worth
in the department of psychiatry. “Full
anorexia nervosa make a par-
mark in defining recovery by weight
recovery means that patients can find
and/or eating disorder symptoms in the
tial recovery, but just 21%
make a full recovery, a mile-
stone most likely to signal per- joy in their daily life, free from the physi- absence of these other factors.”
cal and psychological effects caused by
Parents reinforced clinicians’ obser-
manent remission. restrictive dieting.” vations that physical and behavioral
These results, and more, are drawn For the study, partial recovery, she recovery, which includes resuming reg-
from an online survey of 387 parents, of says, was defined as showing some ular eating habits, precede cognitive
whom 83% had children with anorexia improvement but still symptomatic in recovery, in which patients are no longer
nervosa, 6% with atypical anorexia ner- at least one of the following areas: physi- plagued by extreme fear of weight gain
vosa—a variant occurring in patients cal health, eating disorder thoughts and and body image distortion.
who aren’t underweight—and the behaviors, social functioning, or mood. Among the patients—whose average
remainder with other eating disorders. Among the 21% (81 patients) who age was 18, with a five-year history of
The findings are reported in a study led made a complete recovery, 94% had the disorder—90% were female, 94%
by the University of California, San Fran- managed to maintain their recovery two were white, and 90% lived in the United
cisco (UCSF) and published in the Inter- years later. “Unfortunately, patients who States, Canada, the United Kingdom, or
national Journal of Eating Disorders. achieved only partial recovery continued Australia.
“This study reminds us that we need to struggle and were much more suscep- In a follow-up study, Accurso and
to work harder to help individuals with tible to relapse,” Accurso notes. colleagues will look at how weight
anorexia nervosa who are not respond- Previous studies have found that restoration, including the goal weight
ing to standard treatment,” says first around 50% of patients with anorexia set by a patient’s clinician, impacts the
author Erin C. Accurso, PhD, clinical nervosa made complete recoveries, recovery process.
director of the UCSF Eating Disorders but this study had a preponderance of SOURCE: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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