Monday, February 27, 2023

APA Releases Revamped Practice Guideline on Eating Disorders

APA has released an updated practice guideline on how to assess and treat patients with eating disorders—the first full update since 2006. The fourth edition of APA’s Practice Guideline for the Treatment of Patients With Eating Disorders reflects numerous new research findings since 2006 as well as diagnostic changes following the publication of DSM-5 in 2013 and DSM-5-TR in 2022.

“Eating disorders often are unrecognized and untreated,” noted Catherine Crone, M.D., chair of the practice guideline writing group, in an APA press release. “This guideline and supplementary resources are intended to serve as a practical tool for clinicians to help with screening, diagnosis, and providing evidence-based treatment for eating disorders.”

The updated guideline includes 16 clinical recommendations or suggestions related to anorexia nervosa, bulimia nervosa, and binge-eating disorder, including:

  • Screening for the presence of an eating disorder as part of an initial psychiatric evaluation.
  • Conducting comprehensive patient evaluations, including laboratory tests such as electrocardiograms.
  • Formulating patient-centered and culturally sensitive treatment plans.
  • Setting individualized weight goals for patients with anorexia.
  • Treating patients with anorexia, bulimia, or binge-eating disorders with eating disorder–focused psychotherapy.
  • Including family-based therapy as part of a treatment plan for adolescents with anorexia or bulimia.

The guideline also includes information on how to of evaluate patients for avoidant/restrictive food intake disorder (ARFID), which was added to DSM-5; however, due to limited clinical data, there are no specific recommendations for how to treat patients with ARFID.

To provide additional assistance to health professionals, APA has developed supplemental materials, such as a clinician pocket guide and an online course designed to introduce learners to concepts in the new guideline. Soon to be released are a guide for patients/families and an interactive clinical decision support tool.

“Early identification and treatment of an eating disorder is critical for achieving positive long-term outcomes,” said Joel Yager, M.D., a professor emeritus of psychiatry at the University of Colorado School of Medicine and the chair of the writing group for the three previous editions of the eating disorders practice guideline. “We hope that this tool will help anyone make an informed diagnosis regardless of their previous experience with eating disorders.”

To read more on this topic, see the Psychiatric News article “Special Report: Youth With Eating Disorders—Time Is of the Essence in Achieving Remission.”

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