Clinical Practice Guideline for Eating Disorders.

  1. Introduction
  2. Scope and Objectives
  3. Methodology
  4. Definition and Classification of Eating Disorders
  5. Prevention of Eating Disorders
  6. Detection of Eating Disorders
  7. Diagnosis of Eating Disorders
  8. Interventions at the Different Levels of Care in the Management of Eating Disorders
  9. Treatment of Eating Disorders
  10. Assessment of Eating Disorders
  11. Prognosis of Eating Disorders
  12. Legal Aspects Concerning Individuals with Eating Disorders in Spain
  13. Detection, Diagnosis and Treatment Strategies for Eating Disorders
  14. Dissemination and Implementation
  15. Recommendations for Future Research
  16. Bibliography

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15. Future research recommendations

The following studies are required:

Studies that clarify the benefits, versus potential risks, of primary prevention programmes in schools and in mass media.

Studies that describe the value of preventive interventions (screening and risk factors) in childhood and adolescence, considered the highest risk group for developing eating disorders.

Studies that improve evidence regarding the choice of the treatment prescribed, the selection of other specific instruments and the expected duration and intensity of treatment in order to achieve the best results (immediate and long-term), based on clearly defined clinical indicators and on a more precise description of the stages of these disorders.

Studies that determine predisposing and precipitating biological and genetic risk factors for eating disorders. Also determine environmental, neuropsychological and personality risk factors that serve as precursors-protectors of eating disorders.

Studies that address proper methods for the treatment of osteopenia, osteoporosis and other “diseases-sequelae” of AN.

In the case of AN, studies that assess specific treatments for your patients, who are probably more sensitive to treatment and should be differentiated from treatments designed for older patients and patients with more chronic diseases, since that the characteristics and response to treatment, in other diseases, varies between these groups. Large multi-centre studies with adequate strength and required given that it is hard to recruit and retain patients with AN in controlled treatment studies due to the high dropout rate.

In the case of BN, studies that help to determine predictive factors of therapeutic success-failure and early predictors of change. Better studies are also required to address the treatment of complex cases with multiple comorbidities that are so common in health care practice.

In the case of BED, combined with obesity, studies on the best sequence of treatments (for example, if BED treatment precedes, or not, weight management treatment) and on the long-term benefits of treatment in terms of eating disorder symptoms and weight.

Studies that analyse in depth the clinical-phenomenological intrinsic characteristics of EDNOS (clinical and personality) and the efficacy of specific therapeutic approaches.

Studies that analyse the clinical-phenomenological characteristics of less prevalent eating disorder groups (late onset, males, etc.) and the efficacy of specific treatments.

Studies on the development and validation of SH therapeutic programmes not only in a printed format, but also and especially using the latest technological instruments (computerised manuals) and remote help (online, telephone support, etc.).

Studies that analyse endophenotypes associated with eating disorders (purging cases, impulsive subgroups, etc.) and therapeutic efficacy. Studies that analyse cognitive styles and neuropsychological processes involved in the onset and maintenance of eating disorders.

Studies that analyse the clinical impact of comorbidity (Axis I and II) on eating disorders and specific therapeutic efficacy.

Additionally, it would be necessary to design and analyse specific therapeutic approaches in these patient groups.

Studies that provide an in-depth analysis of diagnosis modification and factors involved in eating disorders.

Studies on the efficacy-efficiency of health care resources: structural and management aspects.

Studies that provide an in-depth analysis of the utility of new technologies (telemedicine, Internet, short mobile text messages [sms], videogames), as an additional therapeutic tool and in specialist education and training procedures.

Studies on neuroimaging, to facilitate an understanding of the morphological and functional involvement of certain brain areas in eating disorders (biological, environmental and personality vulnerability, nutritional changes associated with eating disorders, areas that regulate fullness-hunger sensations and therapeutic efficacy).

Animal and human studies on the mechanisms that regulate eating, versus energy expenditure.

Studies on the links between physiological and psychological processes of puberty and the onset of eating disorders.

Studies on the effects of exercise, including the role of extreme exercise and eating restraint, on the onset and development of eating disorders; and the opposite, the possible protective effect of some healthy popular athletes on boys’ and girls’ attitudes towards exercise, diet, weight and shape.

Studies on the impact of several comorbidities (including mood disorders, anxiety disorders, disorders related with substance abuse, personality disorders and others) frequently associated with the development of eating disorders and response to treatment.

Sociological studies on social values and eating disorders.

Family studies on factors associated with the onset and maintenance of eating disorders and the impact of these disorders on other family members.

Latest update: January 2010

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