CPG for Eating Disorders

Health care professionals can consider providing BED patients with SH programmes (guided ornot) that may yield positive results. However, this treatment is only effective in a limitednumber of patients with BED (Grade B). Recommendation 9.GP.14.– If there is a lack of evidence to guide the care of patients with EDNOS or BED, health careprofessionals are recommended to follow the eating disorder treatment that most resemblesthe eating disorder the patient presents. (Grade D). Recommendation 9.GP.15.– IPT should be considered an alternative to CBT although patients should be informed that itrequires 8 to 12 months to achieve results similar to those obtained with CBT. (Grade B).Recommendation 9.5.2.1.IPT-BED can be offered to patients with persistent BED. (Grade B). Recommendation9.5.3.1.4) Pharmacological interventions– In the treatment of BN pharmacological treatments other than antidepressants are notrecommended (Grade B). Recommendation 9.9.2.1.2.Patients should be informed that antidepressant treatment can reduce the frequency of bingeeatingand purging but effects are not immediate. (Grade B) Recommendation 9.9.2.1.1.The dose of fluoxetine used in patients with BN is greater than the dose used for treatingdepression (60 mg/day). (Grade D). Recommendation 9.9.2.1.3.Amongst SSRI antidepressants, fluoxetine is the first-choice drug for treatment of BN, in termsof acceptability, tolerability and symptom reduction. (Grade D). Recommendation 9.9.2.1.4.– SSRI antidepressant treatment can be offered to a patient with BED, regardless of whetherhe/she follows a guided SH programme or not. (Grade B). Recommendation 9.9.3.1.1.Patients must be informed that SSRI antidepressant treatment can reduce the frequency of bingeeating,but the duration of long-term effects is unknown. Antidepressant treatment may bebeneficial for a small number of patients. (Grade B). Recommendation 9.9.3.1.2.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS205