Treatments for Eating Disorders

2007 ◽  
pp. 579-610 ◽  
Author(s):  
G. Terence Wilson ◽  
Christopher G. Fairburn
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Antidepressant Medication ◽  
Cognitive Behavioral ◽  
Short Term ◽  
The Core ◽  
Core Features

A very substantial number of well-designed studies (Type 1 and Type 2) have shown that manual-based cognitive-behavioral therapy (CBT) is currently the treatment of choice for bulimia nervosa (BN); roughly half of patients receiving CBT cease binge eating and purging. Well accepted by patients, CBT is the most effective means of eliminating the core features of the eating disorder and is often accompanied by improvement in psychological problems such as low self-esteem and depression; long-term maintenance of improvement is reasonably good. A large number of good to excellent outcome studies (Type 1 and Type 2) suggest that different classes of antidepressant drugs produce significantly greater reductions in the short term for binge eating and purging in BN patients than a placebo treatment; the long-term effects of antidepressant medication on BN remain untested. There is little evidence that combining CBT with antidepressant medication significantly enhances improvement in the core features of BN, although it may aid in treating comorbid anxiety and depression. The continuing paucity of controlled research on outcomes of treatment for anorexia nervosa (AN) contrasts sharply with the quantity and quality of research on outcomes of treatment for BN and binge-eating disorder (BED). Nevertheless, a specific form of family therapy, referred to as the Maudsley Model, has shown promising effects on AN in adolescent patients, although this remains to be shown to be a specific effect. Several different psychological treatments appear equally effective in reducing the frequency of binge eating in the short term in BED; these treatments include CBT, interpersonal therapy (IPT), behavioral weight loss programs, and guided self-help based on cognitive-behavioral principles. To date, only CBT and IPT have been shown to have significant longer term effects in eliminating binge eating. Evidence on the specific effects of antidepressant medication on BED is mixed. As yet, there has been no research on the treatment of the most common eating disorder diagnosis, “eating disorder not otherwise specified.”

scholarly journals The Efficacy of Mobile Phone Apps for Lifestyle Modification in Diabetes: Systematic Review and Meta-Analysis (Preprint)

2018 ◽  
Author(s):  
Xinghan Wu ◽  
Xitong Guo ◽  
Zhiwei Zhang
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Mobile Phone ◽  
Lifestyle Modification ◽  
Meta Analysis ◽  
Short Term

BACKGROUND Diabetes and related complications are estimated to cost US $727 billion worldwide annually. Type 1 diabetes, type 2 diabetes, and gestational diabetes are three subtypes of diabetes that share the same behavioral risk factors. Efforts in lifestyle modification, such as daily physical activity and healthy diets, can reduce the risk of prediabetes, improve the health levels of people with diabetes, and prevent complications. Lifestyle modification is commonly performed in a face-to-face interaction, which can prove costly. Mobile phone apps provide a more accessible platform for lifestyle modification in diabetes. OBJECTIVE This review aimed to summarize and synthesize the clinical evidence of the efficacy of mobile phone apps for lifestyle modification in different subtypes of diabetes. METHODS In June 2018, we conducted a literature search in 5 databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, and PsycINFO). We evaluated the studies that passed screening using The Cochrane Collaboration’s risk of bias tool. We conducted a meta-analysis for each subtype on the mean difference (between intervention and control groups) at the posttreatment glycated hemoglobin (HbA1c) level. Where possible, we analyzed subgroups for short-term (3-6 months) and long-term (9-12 months) studies. Heterogeneity was assessed using the I2 statistic. RESULTS We identified total of 2669 articles through database searching. After the screening, we included 26 articles (23 studies) in the systematic review, of which 18 studies (5 type 1 diabetes, 11 type 2 diabetes, and 2 prediabetes studies) were eligible for meta-analysis. For type 1 diabetes, the overall effect on HbA1c was statistically insignificant (P=.46) with acceptable heterogeneity (I2=39%) in the short-term subgroup (4 studies) and significant heterogeneity between the short-term and long-term subgroups (I2=64%). Regarding type 2 diabetes, the overall effect on HbA1c was statistically significant (P<.01) in both subgroups, and when the 2 subgroups were combined, there was virtually no heterogeneity within and between the subgroups (I2 range 0%-2%). The effect remained statistically significant (P<.01) after adjusting for publication bias using the trim and fill method. For the prediabetes condition, the overall effect on HbA1c was statistically insignificant (P=.67) with a large heterogeneity (I2=65%) between the 2 studies. CONCLUSIONS There is strong evidence for the efficacy of mobile phone apps for lifestyle modification in type 2 diabetes. The evidence is inconclusive for the other diabetes subtypes.

scholarly journals Sustainable Development of the Steppe in the Region of El Bayadh, Approach to a New Fattening System

2020 ◽  
pp. 30-37
Author(s):  
Mekhloufi Moulay Brahim ◽  
Mohamed Khader ◽  
Tayeb Nouri ◽  
Mahari Latifa
Keyword(s):  
Sampling Method ◽  
Farming Systems ◽  
Breeding Systems ◽  
Short Term ◽  
Land Use Patterns ◽  
Use Patterns ◽  
Type 3

The objective of this research is to follow the evolution and sustainability of the natural resource management systems adopted by different breeders found in the Al Bayadh region in Algeria. Using a stratified sampling method, 52 farms were surveyed between 2010 and 2015 to capture the diversity of farming systems and identify changes in land use patterns. The findings of the research reveal a predominance of sedentary and semi-transhumant farming systems with a sharp decline in nomadism. This study enabled us to identify three types of breeding: sedentary breeding systems with short-term fattening (type 1), semi-sedentary systems with medium-term fattening (type 2), and transhumant/nomadic systems with long-term fattening (type 3) that therefore reflect a diversity of actions in the management of the risk that threaten livestock production.

Abstract #238: Improved Short Term and Long Term Outcomes of Early Insulin Initiation in Type 2 Diabetes Over 10 Years

2017 ◽  
Vol 23 ◽  
pp. 50
Author(s):  
Jothydev Kesavadev ◽  
Shashank Joshi ◽  
Banshi Saboo ◽  
Hemant Thacker ◽  
Arun Shankar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Initiation ◽  
Long Term Outcomes ◽  
Short Term

scholarly journals Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic

2021 ◽  
Vol 9 (1) ◽  
pp. e002035
Author(s):  
Merel M Ruissen ◽  
Hannah Regeer ◽  
Cyril P Landstra ◽  
Marielle Schroijen ◽  
Ingrid Jazet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Weight Gain ◽  
Glycemic Control ◽  
Perceived Stress ◽  
Medical Center ◽  
Short Term ◽  
Design And Methods

IntroductionLockdown measures have a profound effect on many aspects of daily life relevant for diabetes self-management. We assessed whether lockdown measures, in the context of the COVID-19 pandemic, differentially affect perceived stress, body weight, exercise and related this to glycemic control in people with type 1 and type 2 diabetes.Research design and methodsWe performed a short-term observational cohort study at the Leiden University Medical Center. People with type 1 and type 2 diabetes ≥18 years were eligible to participate. Participants filled out online questionnaires, sent in blood for hemoglobin A1c (HbA1c) analysis and shared data of their flash or continuous glucose sensors. HbA1c during the lockdown was compared with the last known HbA1c before the lockdown.ResultsIn total, 435 people were included (type 1 diabetes n=280, type 2 diabetes n=155). An increase in perceived stress and anxiety, weight gain and less exercise was observed in both groups. There was improvement in glycemic control in the group with the highest HbA1c tertile (type 1 diabetes: −0.39% (−4.3 mmol/mol) (p<0.0001 and type 2 diabetes: −0.62% (−6.8 mmol/mol) (p=0.0036). Perceived stress was associated with difficulty with glycemic control (p<0.0001).ConclusionsAn increase in perceived stress and anxiety, weight gain and less exercise but no deterioration of glycemic control occurs in both people with relatively well-controlled type 1 and type 2 diabetes during short-term lockdown measures. As perceived stress showed to be associated with glycemic control, this provides opportunities for healthcare professionals to put more emphasis on psychological aspects during diabetes care consultations.

Sign in / Sign up

Export Citation Format

Share Document