CPG for Eating Disorders

95% CI: 0.58 to 1.63) and purging (3 RCTs; N=92; Cooper, 1995 225 ;Wilson,1991 226 ;Agras, 1989 222 ; RR: 0.88; 95% CI: 0.62 to 1.24) by the end of treatment.There is sufficient evidence to determine that CBT-BN-ERP is superior to CBT-BNalone in the remission of binge-eating (RR: 1.20; 95% CI: 0.52 to 2.79) and purging(RR: 1.60; 95% CI: 0.76 to 3.36) at follow-up after the end of treatment (1 RCT; N=22;Cooper, 1995) 225 .There is not sufficient evidence to suggest that CBT-BN-ERP treatment is superior toCBT-BN in reducing the frequency of binge-eating (1 RCT; N= 27; Cooper, 1995 225 ;SMD: -0.25 95% CI: -1.01 to 0.50) and purging (3 RCTs: N=83; Agras 2000 227 ;Cooper, 1995 225 , Lenteinberg, 1988 223 ; SMD: -0.17; 95% CI:-0.60 to 0.27) by the end oftreatment.There is not sufficient evidence to suggest that CBT-BN-ERP treatment is superior toCBT-BN in reducing the frequency of purging at follow-up after the end of treatment(2 RCTs; N=48; Cooper, 1995 225 ; Lenteinberg, 1988 223 ; SMD= -0.47; 95% CI: -1.06 to0.11).RCT1 ++RCT1 +RCT1 ++There is limited evidence that indicates that CBT-BN-ERP treatment is superior toCBT-BN in reducing the frequency of purging episodes at follow-up after the end oftreatment (1 RCT; N=25; Wilson, 1991 226 ; SMD: -0.90; 95% CI: -1.73 to -0.07).There is strong evidence that suggests that CBT-BN treatment is more effective thanIPT-BN in the remission of binge-eating (2 RCTs; N=270; Agras, 2000 227 ; Fairburn,1986 228 ; RR: 0.77; 95% CI: 0.67 to 0.87; NNT: 5; 95% CI: 4 a 20) and purging by theend of treatment (1 RCT; N=220; Cooper, 1995 225 ; RR: 0.76; 95% CI: 0.67 to 0,86;NNT: 5; 95% CI: 4 a 8).There is evidence that it is not likely that there are significant differences betweenCBT-BN and IPT-BN treatments in the remission of binge-eating episodes by the endof treatment and at follow-up (2 RCTs; N=270; Agras, 2000 227 ; Fairburn, 1986 228 ; RR:0.93; 95% CI: 0.82 to 1.06).It is not likely that CBT-BN is superior to IPT-BN in reducing the frequency of bingeeating(2 RCTs; N=262;Agras, 2000 227 ; Fairburn, 1986 228 ; SMD: -0.24; 95% CI: -0.48 to0.01) and purging (2 RCTs; N=257; Agras, 2000 227 ; Fairburn, 1986 228 ; SMD: -0.04;95% CI: -0.29 to 0.20) by the end of treatment.There is sufficient evidence that there may be significant differences between CBT-BNvs. PDT in the frequency of binge-eating (1 RCT; N=46; Garner, 1993 229 ; SMD: -0.19;95% CI: -0.77 to 0.39) and purging (1 RCT; N=50; Garner, 1993 229 ; SMD: -0.56; 95%CI: -1.13 to 0.01) by the end of treatment.It is not likely that CBT-BN is superior to FSP (focal supportive psychotherapy) inreducing the frequency of binge-eating (3 RCTs; N=111; Fairburn, 1991 224 ; Freeman,1988 220 ; Wolf, 1992 221 ; SMD: 0.00; 95% CI: -0.37 to 0.38) and purging episodes (4RCTs, N=144; Fairburn, 1991 224 ; Freeman, 1988 220 ; Wolf, 1992 224 , Agras, 2000 227 ;SMD:-0.13; 95% CI: -0.46 to 0.20) by the end of treatment.RCT1 ++RCT1 ++RCT1 ++RCT1 ++RCT1 ++RCT1 ++100CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS