EATING DISORDERS - EFFICACY OF PHARMACOLOGICAL AND PSYCHOLOGICAL INTERVENTIONS

Eating disorders represent a spectrum of overlapping conditions that c ombine disturbances in eating with various forms of traditional psycho pathology. Medications are often helpful in the management of the psyc hopathology associated with anorexia nervosa but no compound has been shown to assist weight gain reliably or alter other core features of t he condition. Contingency management and other behavior therapy proced ures are effective in promoting weight gain in anorexia nervosa. The L imited effectiveness of cognitive interventions for anorexia nervosa m ay be due to the complex of physical symptoms associated with low body weight. Antidepressants reduce binging and purging in bulimia nervosa and binge eating disorder although this action appears to be independ ent of any antidepressant effect. Cognitive/behavioral interventions a lso reduce binging and purging, and comparisons of this therapy with m edication indicate that psychotherapy alone is more effective than med ication alone. Moreover, changes produced by cognitive/behavioral inte rventions endure longer than medication where higher relapse rates are common. Most studies also reveal no advantage of medication over cogn itive/behavioral therapy alone in the reduction of bulimic symptoms. C opyright (C) 1996 Elsevier Science Ltd