News taken from www.paloaltoonline.com

I would like to see more mind-body approaches applied to treating Eating Disorders, but I support their efforts in this study.

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Stanford, Packard hospitals to seek answers to stubborn disorder under five-year, $2-million grant

by Sue Dremann
Palo Alto Online Staff

The largest study in the nation of adolescents with bulimia nervosa is seeking volunteers at Stanford.

An eating disorder characterized by binging and purging, bulimia starts out slowly. But doctors have never pinpointed how best to heal the disease before its destructive cycle gains years of momentum.

The study is significant because only two small randomized trials have previously been done for adolescents.

Psychiatrists at the Stanford University School of Medicine and the University of Chicago received a five-year, $2 million grant from the National Institute of Mental Health to compare bulimia treatments for young people, a vastly understudied group, but often a demographic in which the disease takes root.

Full-blown bulimia affects 1 to 2 percent of adolescents and another 2 to 3 percent display significant bulimic behaviors, according to James Lock, M.D., professor of psychiatry and behavioral sciences at Stanford and the study's senior investigator. Female patients outnumber males 5 to 1, he said.

"We desperately need more information. There are a lot of kids with these problems and we don't know how to help them," Lock, who is also director of psychiatric services at the Comprehensive Eating Disorders Program at Lucile Packard Children's Hospital.

Bulimia stems from poor body image and an unhealthy focus on rigid dieting. Strict dieting sets up patients for lapses of control -- binge-eating episodes. After binge eating on thousands of calories, patients purge with vomiting, laxatives or excessive exercise. They then feel guilty over their loss of control, fueling further negative thoughts and deepening the downward spiral, he said.

The team will study three treatments that may help adolescent bulimics. Study subjects will be randomly assigned to receive 20 outpatient consultations using cognitive behavioral therapy, family therapy or individual psychotherapy.

Cognitive behavioral therapy works to change patients' behaviors and thinking patterns related to food and body image. The therapist aims to help the patient stop thoughts that overemphasize the importance of weight and shape and end severe, destructive dieting.

Family therapy focuses on eating behaviors. The patient's parents are involved in every therapy session, and changes in the home environment reinforce healthy eating and discourage dieting.

Individualized psychotherapy examines underlying life problems that contribute to negative self-image, Lock said.

Cognitive behavioral therapy is widely recognized as the preferred bulimia treatment for adults, whereas family therapy is used in teens with anorexia nervosa. Individual psychotherapy has succeeded as an alternate treatment for bulimic adults and adolescents, he said.

The research team plans to enroll 158 adolescents, 79 at each study site. Prospective participants must be boys or girls ages 12 to 18 with bulimia nervosa or significant bulimic behaviors. Participants and their families must be willing to be assigned to any of the three treatments, and agree to participate in six months of regular treatments and one year of follow-up.

"We hope early intervention will become a chronic, long-lasting strategy," Lock said.
Instead of treating bulimia in adulthood, "after the horse is out of the barn," early treatment has a better shot at achieving a lasting cure, he added.

Interested individuals should contact research assistant Brittany Alvy at 650-723-9182.