Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration , although its efficacy in the underweight state remains unknown .
Variants of family therapy are efficacious in adolescents , but not in adults .
Evidence for AN treatment is weak ; evidence for treatment-related harms and factors associated with efficacy of treatment are weak ; and evidence for differential outcome by sociodemographic factors is nonexistent .
OBJECTIVE The RTI International-University of North Carolina at Chapel Hill Evidence -based Practice Center ( RTI-UNC EPC ) systematic ally review ed evidence on efficacy of treatment for anorexia nervosa ( AN ) , harms associated with treatments , factors associated with treatment efficacy , and differential outcome by sociodemographic characteristics .
The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa.
To study the effects of prolonged anorexia nervosa on bone density ( BD ) and to determine whether estrogen administration prevents bone loss in women with this disorder , 48 amenorrheic women with anorexia nervosa ( mean age , 23.7 yr ) were r and omized to receive estrogen and progestin replacement ( n = 22 ) or no replacement ( n = 26 ) . Clinical variables , biochemical indices , and spinal trabecular BD were measured every 6 months for a mean of 1.5 yr . Initial mean BD ( 130 + /- 27 mg K2HPO4/cm3 , + /- 1 SD ) was significantly ( P < 0.001 ) less than normal ( 176 + /- 26 mg K2HPO4/cm3 ) and less than 2 SD below normal in 21 of the 48 women . Forty-four women completed the study ( 19 in the estrogen group and 25 in the control group ) . The mean duration of follow-up was comparable in the estrogen-treated ( 1.57 + /- 0.89 yr ) vs. the control group ( 1.41 + /- 0.69 yr ) . The estrogen-treated group had no significant change in BD compared with the control group ; however , there was a 4.0 % increase in mean BD in patients with an initial ideal body weight of less than 70 % who were treated with estrogen . In contrast , control patients with comparably low initial weight had a 20.1 % decrease in BD . Women in the control group with spontaneous resumption of menses , all of whom had an initial percent ideal body weight of greater than 70 % , had a 19.3 % increase in bone mass . It is concluded that : 1 ) estrogen replacement can not prevent progressive osteopenia in young women with anorexia nervosa ; 2 ) a subset of patients may have improved BD with estrogen and progestin administration depending on initial body weight ; and 3 ) recovery from anorexia nervosa is associated with significantly improved BD
Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration , although its efficacy in the underweight state remains unknown .
Variants of family therapy are efficacious in adolescents , but not in adults .
Evidence for AN treatment is weak ; evidence for treatment-related harms and factors associated with efficacy of treatment are weak ; and evidence for differential outcome by sociodemographic factors is nonexistent .
OBJECTIVE The RTI International-University of North Carolina at Chapel Hill Evidence -based Practice Center ( RTI-UNC EPC ) systematic ally review ed evidence on efficacy of treatment for anorexia nervosa ( AN ) , harms associated with treatments , factors associated with treatment efficacy , and differential outcome by sociodemographic characteristics .