CPG for Eating Disorders

Scientific EvidenceThere is insufficient evidence to indicate clinically significant differences between SHand wait-list in the number of dropouts for any reason by the end of treatment (3 RCTs,N=183; Carter, 2003 242 ; Mitchel, 2001 258 ; Treasure, 1994 231 ; RR: 0.68; 95% CI: 0.38 to1.19).There is insufficient evidence to indicate clinically significant differences between GSHand wait-list in the number of dropouts for any reason by the end of treatment (1 RCT;N=47;Walsh, 2004 328 ; RR: 1.38; 95% CI: 0.98 to 1.96).In an RCT (Durand and King, 2003 259 ), the overall dropout rate was 21%. Dropouts pergroups were: SH by family physician, 24%; specialist treatment, 18%. No adverseeffects were reported.In an RCT (Carter, 2003) 242 the dropout rate in the CBT manual group was 18%; nonspecifictreatment, 25%; wait-list, 28%. No adverse effects were reported.RCT1+RCT1+RCT1+RCT1+Summary of the Evidence(See summary of the evidence for psychological treatment)Recommendations(See recommendations 9.GP.12 to 9.GP.17)9.4.2. Binge-Eating Disorder9.4.2.1. What is the efficacy of SH and GSH in patients with BED?The answer is based on the NICE CPG (2004) 30 and on three high-quality SRSE (1++): the oneelaborated by the AHRQ 31 , a Cochrane 257 review and a more recently published one by Brownley,et al., 2007 245 . The updated search has not yielded any new evidence.Variable: BMIThere is insufficient evidence to determine that there are clinically significantdifferences between SH and GSH in mean BMI by the end of treatment (2 RCTs,N=109; Loeb 2000 260 ; Carter, 1998 262 ; SMD: 0.08; 95% CI: -0.30 to 0.46) and at followup(1 RCT, N=69; Carter, 1998 262 ; SMD: 0.19; 95% CI: -0.29 to 0.66).RCT1++114CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS