Biomedical Frontiers: Winter/Spring 1996, Vol.3, No.2
Clinical Research
Focusing on Eating Disorders

Research at CPMC is offering new insights into the treatment of eating disorders. Thousands of Americans suffer from eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder.

"The relapse rate for individuals hospitalized for the first time for anorexia nervosa is approximately 50 percent."

Dr. Kathleen Pike, assistant professor of clinical psychology in psychiatry and chief psychologist of CPMC's Eating Disorders Clinical Research Service, is conducting a clinical trial to compare cognitive behavioral therapy (CBT) to nutritional counseling for the treatment of anorexia nervosa.

The study will randomly assign 60 subjects to one year of treatment with either CBT or nutritional counseling; subjects will be followed for two years to determine whether they relapse. The relapse rate for individuals hospitalized for the first time for anorexia nervosa is approximately 50 percent. Typically, at the end of their hospital stays patients are referred for a whole set of treatments, including psychotherapy, medical monitoring, and nutritional counseling. "But there is no documented efficacy for any of these treatments," says Dr. Pike. The study aims to correct that by first investigating the use of CBT for anorexia nervosa. Dr. Pike hopes to design future studies to look at the efficacy of other treatments.

In a separate project, Dr. Michael Devlin, assistant professor of clinical psychiatry, is conducting a study on treatments for binge eating disorder. Subjects in the study receive psychotherapy and are given the option of using medicines-fluoxetine (Prozac) and phentermine (Fastin and others), an appetite suppressant. So far, approximately 30 subjects have begun treatment. Subjects have lost an average of approximately 20 pounds each, most have stopped binge eating, and most show improvements in measures of depression and general psychiatric symptoms, which typically occur with eating disorders.

Dr. B. Timothy Walsh, professor of clinical psychiatry and director of the eating disorders research program at NYSPI, is collaborating with Stanford University in a study to compare CBT with interpersonal therapy (IPT) for the treatment of bulimia nervosa. A prior study from Oxford University found that IPT was just as effective as CBT for the treatment of bulimia nervosa. In another study Drs. Walsh and Evelyn Attia, assistant clinical professor of psychiatry, are investigating whether adding antidepressant medication to the standard inpatient treatment for anorexia nervosa improves patient outcome.

Results of study in which patients with anorexia nervosa received cognitive behavioral therapy in aftercare.

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