Treatment of eating disorders: A systematic meta-review of meta-analyses and network meta-analyses

Alessio Maria Monteleone; Francesca Pellegrino; Giovanni Croatto; Marco Carfagno; Anja Hilbert; Janet Treasure; Tracey Wade; Cynthia M Bulik; Stephan Zipfel; Phillipa Hay; Ulrike Schmidt; Giovanni Castellini; Angela Favaro; Fernando Fernandez-Aranda; Jae Il Shin; Ulrich Voderholzer; Valdo Ricca; Davide Moretti; Daniele Busatta; Giovanni Abbate-Daga; Filippo Ciullini; Giammarco Cascino; Francesco Monaco; Christoph U Correll; Marco Solmi

doi:10.1016/j.neubiorev.2022.104857

Treatment of eating disorders: A systematic meta-review of meta-analyses and network meta-analyses

Neurosci Biobehav Rev. 2022 Nov:142:104857. doi: 10.1016/j.neubiorev.2022.104857. Epub 2022 Sep 6.

Authors

Alessio Maria Monteleone¹, Francesca Pellegrino², Giovanni Croatto³, Marco Carfagno², Anja Hilbert⁴, Janet Treasure⁵, Tracey Wade⁶, Cynthia M Bulik⁷, Stephan Zipfel⁸, Phillipa Hay⁹, Ulrike Schmidt⁵, Giovanni Castellini¹⁰, Angela Favaro³, Fernando Fernandez-Aranda¹¹, Jae Il Shin¹², Ulrich Voderholzer¹³, Valdo Ricca¹⁰, Davide Moretti¹⁰, Daniele Busatta¹⁰, Giovanni Abbate-Daga¹⁴, Filippo Ciullini¹⁵, Giammarco Cascino¹⁶, Francesco Monaco¹⁷, Christoph U Correll¹⁸, Marco Solmi¹⁹

Affiliations

¹ Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy. Electronic address: alessiomaria.monteleone@unicampania.it.
² Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy.
³ Neurosciences Department, University of Padua, Padua, Italy.
⁴ Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
⁵ King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
⁶ Flinders Institute for Mental Health and Well-Being, the Blackbird Initiative, Flinders University, South Australia, Australia.
⁷ Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.
⁸ Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), Germany.
⁹ Translational Health Research Institute, School of Medicine, Western Sydney University, Australia.
¹⁰ Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
¹¹ Department of Psychiatry, Bellvitge University Hospital-IDIBELL and CIBERobn, ISCIII, Barcelona, Spain.
¹² Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
¹³ Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Clinic for Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany; Clinic for Psychiatry and Psychotherapy, University Hospital of Munich, Munich, Germany.
¹⁴ Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
¹⁵ Department of General Psychology, University of Padova, Padova, Italy.
¹⁶ Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy.
¹⁷ Department of Mental Health, Asl Salerno, Salerno, Italy.
¹⁸ Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹⁹ Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.

Abstract

MONTELEONE, A.M., F. Pellegrino, G. Croatto, M. Carfagno, A. Hilbert, J. Treasure, T. Wade, C. Bulik, S. Zipfel, P. Hay, U. Schmidt, G. Castellini, A. Favaro, F. Fernandez-Aranda, J. Il Shin, U. Voderholzer, V. Ricca, D. Moretti, D. Busatta, G. Abbate-Daga, F. Ciullini, G. Cascino, F. Monaco, C.U. Correll and M. Solmi. Treatment of Eating Disorders: a systematic meta-review of meta-analyses and network meta-analyses. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2022.- Treatment efficacy for eating disorders (EDs) is modest and guidelines differ. We summarized findings/quality of (network) meta-analyses (N)MA of randomized controlled trials (RCTs) in EDs. Systematic meta-review ((N)MA of RCTs, ED, active/inactive control), using (anorexia or bulimia or eating disorder) AND (meta-analy*) in PubMed/PsycINFO/Cochrane database up to December 15th, 2020. Standardized mean difference, odds/risk ratio vs control were summarized at end of treatment and follow-up. Interventions involving family (family-based therapy, FBT) outperformed active control in adults/adolescents with anorexia nervosa (AN), and in adolescents with bulimia nervosa (BN). In adults with BN, individual cognitive behavioural therapy (CBT)-ED had the broadest efficacy versus active control; also, antidepressants outperformed active. In mixed age groups with binge-eating disorder (BED), psychotherapy, and lisdexamfetamine outperformed active control. Antidepressants, stimulants outperformed placebo, despite lower acceptability, as did CBT-ED versus waitlist/no treatment. Family-based therapy is effective in AN and BN (adolescents). CBT-ED has the largest efficacy in BN (adults), followed by antidepressants, as well as psychotherapy in BED (mixed). Medications have short-term efficacy in BED (adults).

Keywords: Eating disorders; Psychopharmacology; Psychotherapy; Randomized controlled trials; Treatment; Umbrella review.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adolescent
Adult
Antidepressive Agents / therapeutic use
Binge-Eating Disorder* / drug therapy
Binge-Eating Disorder* / psychology
Bulimia Nervosa*
Bulimia* / drug therapy
Feeding and Eating Disorders* / drug therapy
Humans
Meta-Analysis as Topic
Network Meta-Analysis

Substances

Antidepressive Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding