Adolescents With Eating Disorders May Benefit From Educational Interventions

The efficacy of educational interventions for adolescent patients diagnosed with feeding and eating disorders (FEDs) shows promise but requires additional evidence to confirm therapeutic utility, according to systematic review findings published in Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity.

Patients with FEDs often have a high rate of comorbidity with other psychiatric and medical issues, suggesting the need for a multidisciplinary approach to treatment. Among these therapeutic approaches, educational interventions have gained increased attention for the specific and concrete strategies that provide skills to patients in managing their disorder. With this in mind, the review authors aimed to assess the effect of educational interventions on adolescents with FEDs.

The review authors conducted this systematic review by searching the databases of Scopus, Cochrane Library, ENFISPO, DIALNET, CUIDEN, PsycINFO, CINAHL, and PubMed through June 2023 for articles in English or Spanish related to educational interventions in a young population diagnosed with anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders, and binge-eating disorder. Additionally, reviewers searched grey literature on OpenGrey and Teseo.

Included studies were of quasi-experimental or experimental design that assessed the efficacy of educational interventions in patients with FEDs, aged 12 to 18 years. Studies with anorexia as a symptom (defined as lack of appetite or appetite affected by multiple causes) due to underlying disease were excluded, along with publications in which interventions were directed exclusively at families or support groups. These criteria yielded 10 publications that evaluated the impact of a variety of learning techniques and educational interventions on FEDs in a total of 517 participants.

The studies evaluated in the review measured the effects of educational interventions on learning, improved nutritional knowledge, and positive mental changes toward food/eating. In 4 studies, educational intervention was associated with weight gain in patients and some studies reported decreases in the frequency of vomiting, binge-eating, and purging. Results across studies also show a general trend of more normalized eating patterns following intervention. Furthermore, educational intervention was associated with increased cognitive flexibility in 1 comparative study.

However, the studies included had a wide variability in educational methodologies and assessed outcomes using different tools, making current review comparisons difficult. Risk of bias was also high due to the low methodological quality found in these articles. A small sample size was cited in 6 studies and the vast majority of articles (n=9) only examined FEDs in girls. The heterogeneity in outcome evaluation, groups vs individual settings, and the interventions themselves limit the ability to make clinical recommendations as to therapeutic impact.

Though the authors indicated that educational interventions seem to improve patient knowledge and have a positive effect on health outcomes, the incongruous study elements necessitate further research to robustly support this therapy. The reviewers concluded, “Only by obtaining a deeper understanding, can we generalize our results beyond current studies and provide constructive information for the design of educational programs aimed at this population.”

This review was limited by the inclusion of studies with varying methodological quality and evidence levels, as this significant heterogeneity did not allow for meta-analysis.

This article originally appeared on Psychiatry Advisor