Eating Disorders Clinical Trial
Official title:
Addressing Fear of Food in Anorexia Nervosa
This study will compare the effectiveness of two types of psychotherapy, a relapse prevention program and cognitive behavioral therapy, in reducing relapse and fear of eating situations in people with anorexia nervosa.
Anorexia nervosa (AN) is a serious and often chronic eating disorder characterized by
restrictive eating habits and failure to maintain a healthy minimal body weight. Symptoms of
AN may include distorted body image, fear of weight gain, obsessive exercise, and binge and
purge eating behaviors. In severe cases of AN, a person may practice extreme dieting to
levels of near starvation. These unhealthy behaviors may cause further medical
complications, including organ damage, irregular heart rhythm, premature osteoporosis, and
heart failure. AN has one of the highest mortality rates of all psychiatric disorders,
claiming the lives of up to 6% of those affected. When treated with a form of psychotherapy
and nutritional guidance, people can restore weight to healthy levels and recover from AN,
but the chance of relapse remains high. A program aimed specifically at reducing relapse,
Exposure Therapy and Ritual Prevention with Motivational Enhancement for Relapse Prevention
in Anorexia Nervosa (AN-EX/RP), may be more effective than common psychotherapy treatments,
such as cognitive behavioral therapy (CBT), in enhancing long-term recovery from AN. This
study will compare the effectiveness of AN-EX/RP with CBT in reducing relapse and fear of
eating situations in people with AN.
Participants in this study will include patients who have achieved normal weight while
inpatients at the New York State Psychiatric Unit. Eligible participants will undergo
initial assessments that will include questionnaires, interviews, and two laboratory-based
meals. Participants will then be assigned randomly to receive 6 months of outpatient
psychotherapy treatment with either AN-EX/RP or CBT. Participants assigned to receive
AN-EX/RP will attend 90-minute sessions twice weekly for the first few months, then weekly
thereafter. Sessions will focus on fear of eating situations and will help participants to
confront, rather than avoid, these fears in order to learn through practice that the fears
are unrealistic. Participants assigned to receive CBT will attend treatment sessions twice
weekly for the first month and then weekly thereafter. CBT sessions will focus on thoughts,
feelings, and behaviors that perpetuate the eating disorder, with the aim to develop
healthier patterns. After completing the 6 months of treatment, all participants will repeat
the initial assessments.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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