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People with eating disorders ‘benefit from specialist CBT’, according to NICE

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Cognitive behavioural therapy is among the potential treatments that should be considered for eating disorders, according to the National Institute for Health and Care Excellence.

NICE has published a draft quality standard that recommends a range of possible psychological treatments designed to improve the care of people with eating disorders.

“We want more people with eating disorders to benefit from this type of tailored therapy”

Christopher Fairburn

These include eating-disorder-focused cognitive behavioural therapy (CBT-ED) for adults with anorexia nervosa, and guided self-help programmes for people with binge eating disorders.

“Healthcare professionals should discuss these ‘talking therapies’ with people with anorexia nervosa to help them choose which they would prefer,” stated the standards.

In addition, it noted that first line psychological treatment for children and young people with anorexia nervosa was anorexia-nervosa-focused family therapy in children and young people.

Similarly, the NICE draft standard said children and young people with bulimia-nervosa could participate in focused family therapy (FT-BN) as a treatment option. This would typically consist of 18-20 sessions over six months, noted the standard.

Meanwhile, the use of focused guided self-help programmes as the first psychological treatment for binge eating should include working through a book about the condition, said the standard.

“With the right treatments almost half of people can recover fully from anorexia”

Gillian Leng

There should also be short sessions with a healthcare professional to check on progress – usually there are between four and nine sessions that last about 20 minutes each.

A 2015 report by the eating disorders charity BEAT estimated that there were more than 725,000 people with an eating disorder in the UK – 10% of which have anorexia nervosa and 40% with bulimia.

Professor Christopher Fairburn, director of the Centre for Research on Eating Disorders at Oxford, was a topic expert from the NICE committee that drew up the draft standard.

He said: “This form of specialised CBT can help patients better understand their eating disorder so that they can recognise what causes it to persist and change negative views about themselves and their body.

“We want more people with eating disorders to benefit from this type of tailored therapy so that they can overcome the disorder and be at minimum risk of relapse,” he said.

Professor Gillian Leng, deputy chief executive at NICE said: “Eating disorders affect a large number of the population, both female and male.

“With the right treatments almost half of people can recover fully from anorexia and many others can significantly improve,” said Professor Leng.

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Gillian Leng

“This quality standard highlights the most effective therapies for people with eating disorders and also suggests ways to track people’s progress across different health services,” she said.

“Individual CBT-ED for people with anorexia and other group and self-help programmes for people with binge eating disorder, will help reduce relapse rates and aid recovery.”

NICE quality standards are a set of specific, concise statements and associated measures, covering the treatment and prevention of different diseases and conditions.

They are based on guidance and advice from NICE and other organisations using NICE-accredited processes.

The draft quality standard on eating disorders was mostly derived from existing the NICE guideline on Eating disorders: recognition and treatment.

The draft quality standard is out for public consultation until 3 January 2018. The final version is expected to be published in April 2018.

Quality statements on eating disorders from NICE

  • Statement 1: People with anorexia nervosa have a discussion about their options for first-line psychological treatment
  • Statement 2: People with binge eating disorder participate in guided self-help programmes as first-line psychological treatment
  • Statement 3: Children and young people with bulimia nervosa participate in bulimia-nervosa-focused family therapy
  • Statement 4: People with eating disorders and comorbidities have the impact of all their treatments monitored using outcome measures
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