Evidence-based treatment for the eating disorders

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS), and discusses the role of primary care and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychotherapy, no single approach has been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained "first-line" treatment status with a stronger evidence base than other psychotherapies. Although more trials are needed in BED and EDNOS, less intensive and nonspecialist CBT is likely to be efficacious, combined where appropriate with weight management strategies, either behavioral or pharmacological. Primary care practitioners are in a key role, both with regard to providing care as with co-ordination and initiation of specialist care.