Individual research recommendation details

Recommendation ID

NG69/4

Question

Treating an eating disorder in people with a comorbidity:- What is the impact of comorbidities on treatment outcomes for eating disorders, and what
approaches are effective in managing these comorbidities?

Any explanatory notes
(if applicable)

Why this is important:- People with an eating disorder often have physical comorbidities (such as diabetes) or mental health comorbidities (such as substance abuse, self-harm or obsessive-compulsive disorder). However, there is little evidence on which treatments work best for people with an eating disorder and a comorbidity. A modified eating disorder therapy that addresses both conditions may avoid the need for different types of therapy (either in parallel or one after the other). Alternatively, a comorbidity may be severe enough that it needs addressing before treating the eating disorder, or treatment solely for the eating disorder may help with the comorbidity.
This is a complex area and likely to depend on the severity of the comorbidity and the eating disorder. There is limited evidence and randomised controlled trials are needed. For example, a trial could randomise people with an eating disorder and the same comorbidity (such as type 1 diabetes) to either a modified eating disorder therapy or a non-modified eating disorder therapy. Primary outcome measures may include:
- remission
- binge eating
- compensatory behaviours
- weight or BMI (for studies of anorexia nervosa)
- critical outcomes relating to the specific comorbidity.
There should be at least a 1-year follow up. Mediating and moderating factors that have an effect on treatment effectiveness should also be measured, so that treatment barriers can be addressed and positive factors can be promoted.

Source guidance details

Comes from guidance

Eating disorders: recognition and treatment

Number

NG69

Date issued

May 2017

Other details