Treatment of Feeding and Eating Disorders

Question 1

Why is anorexia nervosa harder to treat than bulimia nervosa or binge-eating disorder?

Answer 1

It is egosyntonic - the person feels good about their eating behaviours - whereas bulimia and binge-eating disorder are egodystonic and cause feelings of guilt, shame, and self-loathing

Question 2

State some early presentations of eating disorders

Answer 2

Increased rigidity in eating behaviour, changes in mood and social withdrawal, cutting out favourite foods, process of denial

Question 3

State the first step in managing an eating disorder

Answer 3

Stabilising the patient

Question 4

State the 3 targets of treatment

Answer 4

Stabilising the patient, normalising eating and weight, and managing physical risk

Question 5

What is the first-line treatment for anorexia nervosa?

Answer 5

Family-based therapy

Question 6

What are second-line treatments for anorexia nervosa?

Answer 6

Eating-disorder targeted CBT or Maudsley anorexia nervosa treatment for adults (MANTRA)

Question 7

Is inpatient care more effective than outpatient-based care?

Answer 7

No

Question 8

What is the standard treatment for binge-eating disorder?

Answer 8

A guided self-help program supplemented with brief supportive sessions

Question 9

Which part of family therapy for anorexia nervosa has been shown to have the greatest impact on recovery?

Answer 9

Inclusion of a family meal

Question 10

Alongside therapy, what should all anorexia nervosa patients be prescribed?

Answer 10

An age-appropriate oral multivitamin and multimineral supplement, until their diet includes enough to meet their dietary reference values

Question 11

What is the first-line treatment for bulimia nervosa?

Answer 11

Family therapy