F.E.A.S.T. - an organization of parents caring for eating disorder patients > Resources

Research: Etiology

Eating Disorders in Children and Adolescents, James Lock, MD
Hope Despite Mortal Risk, full text description of the development of an eating disorder by Dr. Walter Kaye in the American Journal of Psychiatry, December 2009
Click HERE For F.E.A.S.T.'s extensive list of links to literature on the science of eating disorders, treatment, and research.

Research: The Maudsley Method/FBT

NEW: Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. from Behaviour Research and Therapy, February 2012 "Taken together, these results indicate that patients with more severe eating related psychopathology have better outcomes in a behaviorally targeted family treatment (FBT) than an individually focused approach (AFT)."
Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa, from the Archives of General Psychiatry, October 2010
Psychotherapy approaches for adolescents with eating disorders, in Current Opinion in Pediatrics, August 2009. "Regardless of the modality used, some degree of family involvement is important in limiting dropout and improving outcomes"
The Maudsley Model of Family-Based and Parent-to-Parent Consultation, Journal of Marital and Family Therapy, April 2009. "Parents described parent-to-parent consultations as an intense emotional experience that helped them to feel less alone, to feel empowered to progress, and to reflect on changes in family interactions. These results suggest that parent-to-parent consultations are seen as a useful augmentation to the Maudsley model of family-based treatment for anorexia nervosa."
Family therapy in the treatment of adolescent anorexia nervosa: current research evidence and its therapeutic implications. Eating and Weight Disorders, December 2008. "This article summarizes present empirical evidence concerning both family functioning (explanatory dimension) and the effectiveness of family therapy (therapeutic dimension) in anorexia nervosa, and describes resulting changes in theoretical and clinical perspectives."
Family Interventions in Adolescent Anorexia Nervosa, by Daniel le Grange, PhD, and Ivan Eisler, PhD, 2008 (pre-press copy by special permission of the publisher)
The Assessment of the Family of People with Eating Disorders, from the European Eating Disorders Review, 2008. "The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined."

Research: Early Intervention

The relevance of body weight in the medium-term to long-term course of adolescent anorexia nervosa. Findings from a multisite study. from the International Journal of Eating Disorders, January 2009. "Higher BMI prior to onset of AN, higher BMI at first discharge, and lower age at first admission predicted a normal BMI (>17.5) at follow-up in a model of logistic regression."
The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors from The British Journal of Psychiatry, July 2011 "Moreover, the group with an onset in adolescence but who had been ill for over 3 years had a poor response to both family and individual therapy, suggesting that unless effective treatment is given within the first 3 years of illness onset, the outcome is poor."

Research: Malnutrition & Re-feeding

The slippery slope: prediction of successful weight maintenance in anorexia nervosa
By special permission, Practice Paper of the American Dietetic Association: Nutrition Intervention in the Treatment of Eating Disorders
Why is Food Medicine? The Functional Role of Nutrition by Dr. Sarah Ravin for FEAST
They Starved So That Others Be Better Fed: Remembering Ancel Keys and the Minnesota Experiment
Refeeding syndrome – awareness, prevention and management, full text article from Head & Neck Oncology 2009; 1: 4. Published online 2009 January 26.
Abnormal distribution normalizes within a 1-y period of weight maintenance, American Journal of Clinical Nutrition, November 2009 AJCN.27820 Conclusions: "In adult women with AN, normalization of weight in the short term is associated with a distribution of adipose tissue that is consistent with a central adiposity phenotype. This abnormal distribution appears to normalize within a 1-y period of weight maintenance."
"Does Percent Body Fat Predict Outcome in Anorexia Nervosa"
"intake of energy-dense foods and a greater variety of foods may be crucial to relapse prevention"
Seasonality and the prediction of weight at resumption of menses in anorexia nervosa

Research: Predicting Target Weight

Predicting the weight gain required for recovery from anorexia nervosa with pelvic ultrasonography: An evidence-based approach European Eating Disorders Review, Volume 18, Issue 1, pages 43–48, January/February 2010
Determinants of height in adolescent girls with anorexia nervosa. Pediatrics. 2008 Jun;121(6):e1517-23. "Our data suggest that preservation of height potential in this cohort of girls with anorexia nervosa may be a consequence of delayed bone age. Hypogonadism may negate the deleterious effects of undernutrition on stature by allowing for a longer duration of growth."

Research: AN Outcome Predictors

The following factors seem to predict better recovery rates for patients with Anorexia Nervosa:

Higher initial rate of weight gain during re-feeding. (over 0.8 kg/week, or 1.75lbs/week) Study: Rate of inpatient weight restoration predicts outcome in anorexia nervosa.
Younger age of diagnosis and Higher BMI at diagnosis and discharge: (BMI >17.5 in adolescents age 10-18) Study: The relevance of body weight in the medium-term to long-term course of adolescent anorexia nervosa. Findings from a multisite study.
Early intervention: (within the first 3 years after diagnosis) Study: The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors
Higher percentage of body fat at weight restoration. Study: Does percent body fat predict outcome in anorexia nervosa?
Higher energy density and variety of foods during re-feeding and weight restoration. Study: Dietary energy density and diet variety as predictors of outcome in anorexia nervosa.
Higher levels of weight restoration and the avoidance of weight loss immediately following acute treatment. Study: The slippery slope: prediction of successful weight maintenance in anorexia nervosa.Study: What predicts maintenance of weight for adolescents medically hospitalized for anorexia nervosa?
Continuation of high calorie intake and low activity levels up to 6 months after weight restoration. Study: Caloric consumption and activity levels after weight recovery in anorexia nervosa: A prolonged delay in normalization.

Research: EDs and Sports

Sport and Eating Disorders - Understanding and Managing the Risks, A. Currie, MD, Asian J Sports Med. June 2010
Prevalence of eating disorders in elite athletes is higher than in the general population, Clin J Sport Med. January 2004
The Female Athlete Triad: An Emerging Role for Physical Therapy, P. Papanek, J Orthop Sports Phys Ther. 2003

Research: Maintaining Factors

A Neural Signature of Anorexia Nervosa in the Ventral Striatal Reward System, October, 2009, "findings are consistent with predictions in animal studies of the pivotal role of the human reward system in anorexia nervosa and thus support theories of starvation dependence in maintenance of the disorder."

Research: Resistance to Treatment

Treatment of Anorexia Nervosa against the Patient’s Will: Ethical Considerations
by Tomas J. Silber, MD Reproduced by permission of the American Academy of Pediatrics: Silber TJ. Treatment of anorexia nervosa against the patient's will: ethical considerations. Adolesc Med State Art Rev. 2011;22(2):283-8, x. "The central issue surrounding involuntary treatment is not whether the patient lacks the capacity to consent or refuse treatment but rather the context and relationships involved in quality care. At the end it is always values that underlie and strengthen the good work. These include fundamental respect for the person, even as liberty is restricted; beneficence; and truth telling."
Perceived Coercion and Change in Perceived Need for Admission in Patients Hospitalized for Eating Disorders Conclusions: "Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization."

Anosognosia Keeps Patients From Realizing They’re Ill, Psychiatric News 2001

Research: Evidence-Based Treatment

Anorexia Nervosa Treatment: A Systematic Review of Randomized Controlled Trials from AHRQ

Bulimia Nervosa Treatment: A Systematic Review of Randomized Controlled Trials from AHRQ

Binge Eating Disorder Treatment: A Systematic Review of Randomized Controlled Trials from AHRQ

F.E.A.S.T. is registered as a nonprofit organization under section 501(c)(3) of the United States Internal Revenue Code.
Information on this site is meant to support, not replace, professional consultation. Unless otherwise noted, content is edited by F.E.A.S.T. volunteers with assistance from our Professional Advisory Panel.

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This page was last updated: 5/21/2013 12:00:00 AM