Randomized Controlled Trial of a Treatment for Anorexia and Bulimia Nervosa

Abstract

The purpose of this study was to help treat patients with the illnesses of anorexia and bulimia nervosa and report their remission and relapse rates with a method of treatment in a randomized controlled trial. These eating disorders are major health problems that occur mostly in young women. Anorexia is when a person eats only small amounts of food while losing body weight, whereas bulimia is when a person eats large amounts of food and vomits immediately after to maintain normal body weight.

To address this, the researchers formed a hypothesis stating that "anorexia develops because it is initially rewarding to eat less and move more." (Bergh, C. & Södersten, P., 1996).

Participants

The sample of this study comprised participants who were either anorexic or bulimic. Although most of them were female, two males also participated. This research encompassed a wide age range, from as young as 10 years old to as old as 54 years. However, the primary participants in this study were predominantly women, with only two men. These patients were divided into their respective groups (treatment or deferred) through a "computer-generated randomization list" (Bergh, C., Eklund, S., Eriksson, M., Lindberg, G. & Sodersten, P., 1996). The patients' BMI ranged from as low as 10.8kg/m² in anorexia nervosa to as high as 31.8kg/m² in bulimia nervosa. Some participants were assigned to a control group and given no treatment, while others were part of the experimental group.

Method/Measure

The researchers in this trial performed an evaluation on each patient by interviewing them about their eating disorder history and physical activity, as well as answering several other questionnaires that estimated their depression, anxiety, and obsession levels. During the measurements for this trial, participants were asked to state their body weight, physical activity, and food intake. Everyone was fed the same amount of food at the same time every day, having three meals a day with snacks in between. Patients even received drug treatments to "enhance gastric motility" in seven anorexic patients (Teitelbaum, P., 2002).

Results

The author concluded their research based on what they found from the trial that was performed. The results of this trial had a significant effect on patients with anorexia and bulimia nervosa. Patients with anorexia had a similar time to remission as patients with bulimia; therefore, the data of the two were combined. The remission rates of patients had improved greatly due to the treatment given. "14 of 16 patients in the treatment group were in remission for 14.4 months, but only one patient in the control group went into remission during the 21.6 month observation period" (Teitelbaum, P., 2002). The author states that, "Six patients (7%) of 83 who were treated to remission relapsed, but the others (93%) have remained in remission for 12 months" (Fig. 4) (Teitelbaum, P., 2002). Although this trial was a success, the author states that there should be improvement in the method, and that this trial should be replicated to test the reliability of success.

Conclusion

In my opinion, this method of treatment provided an accurate answer to the research question. The researchers studied the patients during their full process of going into the remission stage and obtained accurate results, with a large majority of their patients moving into remission, and only a few relapsing during the first year of follow up. During remission, the patients with anorexia and bulimia could eat three meals each day, an improvement from when they started the trial. The authors' conclusions were supported by the research findings. For example, the researchers predicted that 80% of the patients would enter remission through this method of treatment, and the results showed that the estimated rate of remission was about 75%. I believe that the sampling of patients the researchers chose was diverse in terms of age, ranging from as young as ten years old to as old as fifty-four years old. The researchers provided a chart illustrating multiple characteristics of the patients, such as duration of disorder, BMI, number of previous treatments, etc. This information helped the researchers identify common patterns among the patients and identify what they needed to monitor during the trial. However, the researchers did not measure the menstruation of their patients during remission; 30 out of the 41 anorexic patients who went into remission began to menstruate after about three months. The author stated that while the trial achieved outstanding results, they could still further develop their method. For example, the author states, "We need to determine whether one of our interventions is more important than another as well as whether our procedures should be modified" (Bergh, C. & Södersten, P., 1998). This statement implies that even though the success rates of this trial were high, there was still potential for improvement to achieve remission more quickly and prevent relapses. The implications of this study showcase the process of selecting a sample of people that the researchers are interested in, in this case, those diagnosed with an eating disorder, specifically anorexia or bulimia nervosa.

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