Treatment of eating disorders: A systematic meta-review of meta-analyses and network meta-analyses

Alessio Maria Monteleone, Francesca Pellegrino, Giovanni Croatto, Marco Carfagno, Anja Hilbert, Janet Treasure, Tracey Wade, Cynthia M. Bulik, Stephan Zipfel, Phillipa Hay, Ulrike Schmidt, Giovanni Castellini, Angela Favaro, Fernando Fernandez-Aranda, Jae Il Shin, Ulrich Voderholzer, Valdo Ricca, Davide Moretti, Daniele Busatta, Giovanni Abbate-DagaFilippo Ciullini, Giammarco Cascino, Francesco Monaco, Christoph U. Correll, Marco Solmi

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Abstract

MONTELEONE, A.M., F. Pellegrino, G. Croatto, M. Carfagno, A. Hilbert, J. Treasure, T. Wade, C. Bulik, S. Zipfel, P. Hay, U. Schmidt, G. Castellini, A. Favaro, F. Fernandez-Aranda, J. Il Shin, U. Voderholzer, V. Ricca, D. Moretti, D. Busatta, G. Abbate-Daga, F. Ciullini, G. Cascino, F. Monaco, C.U. Correll and M. Solmi. Treatment of Eating Disorders: a systematic meta-review of meta-analyses and network meta-analyses. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2022.- Treatment efficacy for eating disorders (EDs) is modest and guidelines differ. We summarized findings/quality of (network) meta-analyses (N)MA of randomized controlled trials (RCTs) in EDs. Systematic meta-review ((N)MA of RCTs, ED, active/inactive control), using (anorexia or bulimia or eating disorder) AND (meta-analy*) in PubMed/PsycINFO/Cochrane database up to December 15th, 2020. Standardized mean difference, odds/risk ratio vs control were summarized at end of treatment and follow-up. Interventions involving family (family-based therapy, FBT) outperformed active control in adults/adolescents with anorexia nervosa (AN), and in adolescents with bulimia nervosa (BN). In adults with BN, individual cognitive behavioural therapy (CBT)-ED had the broadest efficacy versus active control; also, antidepressants outperformed active. In mixed age groups with binge-eating disorder (BED), psychotherapy, and lisdexamfetamine outperformed active control. Antidepressants, stimulants outperformed placebo, despite lower acceptability, as did CBT-ED versus waitlist/no treatment. Family-based therapy is effective in AN and BN (adolescents). CBT-ED has the largest efficacy in BN (adults), followed by antidepressants, as well as psychotherapy in BED (mixed). Medications have short-term efficacy in BED (adults).

Original languageEnglish
Article number104857
Number of pages20
JournalNEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume142
DOIs
Publication statusPublished - Nov 2022

Keywords

  • Eating disorders
  • Psychopharmacology
  • Psychotherapy
  • Randomized controlled trials
  • Treatment
  • Umbrella review

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