Meta-analysis on the efficacy of psychological treatments for anorexia nervosa

OBJECTIVE: This meta-analysis examines the efficacy of recently developed psychological treatments for anorexia nervosa, compared with control condition. Outcome criteria are weight gain, eating disorder pathology, and quality of life.

METHOD: Twelve thousand nine hundred ninety-seven abstracts, published between 1980 and 2017, were retrieved. End-of-treatment data from 1,279 participants, from 15 of 17 eligible studies, were used to calculate pooled-effect sizes (Hedges' g) for outcome using random-effects model. Subgroup analyses were used to explore the influence of various patient and study characteristics.

RESULTS: No significant differences between psychological treatment and controls were found on weight gain, g = 0.07, 95% CI [-0.09, 0.23], eating disorder pathology, g = 0.06, 95% CI [-0.10, 0.21], and quality of life, g = -0.11, 95% CI [-0.36, 0.15]. Studies including only patients over 18 years of age were more effective on weight gain than studies including adolescents as well. High-quality studies and studies with reported therapist training had larger effects on weight gain and quality of life compared with low-quality studies and studies without reported training.

CONCLUSIONS: Despite progress in the development of specialized treatments, the efficacy of psychological treatment over an active control condition could not be established. Outcomes, however, are obscured by low-quality and heterogeneous studies.