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Eating disorders: outcome, prevention and treatment of eating disorders

Purpose of review Eating disorders remain hard to treat, and difficult to prevent. Recent publications on the outcome of eating disorders, and structured analyses of attempts at prevention, point to a field in need of fresh approaches. Recent findings The outcome of anorexia nervosa does not appear to have altered in the last 50 years. A recent large-scale outcome study found that existing treatments for eating disorders seemed without effect, though many patients with bulimia nervosa did well without making use of specialized treatment. Comprehensive reviews failed to find primary prevention programs to be of benefit and existing theories of the causation of eating disorders seem to lack specificity. Summary Much of the literature on the treatment and outcome of eating disorders lacks methodological robustness and ignores basic epidemiological principles. The absence of authoritative evidence for treatment effectiveness makes it increasingly hard to protect resource intensive treatments in anorexia and bulimia nervosa, and existing theories of the causation of the disorders are too non-specific to generate effective programs of prevention. New models are urgently required.