***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken . Eighty patients ( 57 with anorexia nervosa ; 23 with bulimia nervosa ) were first admitted to a specialized unit to restore their weight to normal . Before discharge , they were r and omly allocated to family therapy or the control treatment ( individual supportive therapy ) . After one year of psychological treatment , they were reassessed , using body weight , menstrual function , and ratings on the Morgan and Russell scales . Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years . A more tentative finding was the greater value of individual supportive therapy in older patients . To our knowledge , this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment BACKGROUND Very limited evidence is available on how to treat adults with anorexia nervosa and treatment outcomes are poor . Novel treatment approaches are urgently needed . AIMS To evaluate the efficacy and acceptability of a novel psychological therapy for anorexia nervosa ( Maudsley Model of Anorexia Nervosa Treatment for Adults , MANTRA ) compared with specialist supportive clinical management ( SSCM ) in a r and omised controlled trial . METHOD Seventy-two adult out- patients with anorexia nervosa or eating disorder not otherwise specified were recruited from a specialist eating disorder service in the UK . Participants were r and omly allocated to 20 once weekly sessions of MANTRA or SSCM and optional additional sessions depending on severity and clinical need ( trial registration : IS RCT N62920529 ) . The primary outcomes were body mass index , weight and global score on the Eating Disorders Examination at end of treatment ( 6 months ) and follow-up ( 12 months ) . Secondary outcomes included : depression , anxiety and clinical impairment ; neuropsychological outcomes ; recovery rates ; and additional service utilisation . RESULTS At baseline , patients r and omised to MANTRA were significantly less likely to be in a partner relationship than those receiving SSCM ( 3/34 v. 10/36 ; P<0.05 ) . Patients in both treatments improved significantly in terms of eating disorder and other outcomes , with no differences between groups . Strictly defined recovery rates were low . However , MANTRA patients were significantly more likely to require additional in-patient or day-care treatment than those receiving SSCM ( 7/34 v. 0/37 ; P = 0.004 ) . CONCLUSIONS Adults with anorexia nervosa are a difficult to treat group . The imbalance between groups in partner relationships may explain differences in service utilisation favouring SSCM . This study confirms SSCM as a useful treatment for out- patients with anorexia nervosa . The novel treatment , MANTRA , design ed for this patient group may need adaptations to fully exploit its potential OBJECTIVE Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits . Using data from a recent r and omized controlled trial , we conducted an incremental cost-effectiveness analysis ( CEA ) of a cognitive-behavioral therapy guided self-help intervention ( CBT-GSH ) to treat recurrent binge eating compared to treatment as usual ( TAU ) . METHOD Participants were 123 adult members of an HMO ( mean age = 37.2 years , 91.9 % female , 96.7 % non-Hispanic White ) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination ( C. G. Fairburn & Z. Cooper , 1993 ) . Participants were r and omized either to treatment as usual ( TAU ) or to TAU plus CBT-GSH . The clinical outcomes were binge-free days and quality -adjusted life years ( QALYs ) ; total societal cost was estimated using costs to patients and the health plan and related costs . RESULTS Compared to those receiving TAU only , those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $ 427 over 12 months following the intervention ( incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY ) . Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group , result ing in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH . CONCLUSIONS Findings support CBT-GSH dissemination for recurrent binge-eating treatment BACKGROUND Currently , without systematic evidence , psychotherapy for anorexia nervosa in adults draws on psychodynamic , cognitive and systemic theories . AIMS To assess effectiveness of specific psychotherapies in out-patient management of adult patients with anorexia nervosa . METHOD Eighty-four patients were r and omised to four treatments : three specific psychotherapies - ( a ) a year of focal psychoanalytic psychotherapy ; ( b ) 7 months of cognitive-analytic therapy ( CAT ) ; ( c ) family therapy for 1 year - and ( d ) low contact , ' routine ' treatment for 1 year ( control ) . RESULTS At 1 year , there was symptomatic improvement in the whole group of patients . This improvement was modest , several patients being significantly undernourished at follow-up . Psychoanalytic psychotherapy and family therapy were significantly superior to the control treatment ; CAT tended to show benefits . CONCLUSIONS Psychoanalytic and family therapy are of specific value in the out-patient treatment of adult patients with anorexia OBJECTIVE Research suggests that family treatment for adolescents with anorexia nervosa may be effective . This study was design ed to determine the optimal length of such family therapy . METHOD Eighty-six adolescents ( 12 - 18 years of age ) diagnosed with anorexia nervosa were allocated at r and om to either a short-term ( 10 sessions over 6 months ) or long-term treatment ( 20 sessions over 12 months ) and evaluated at the end of 1 year using the Eating Disorder Examination ( EDE ) between 1999 and 2002 . RESULTS Although adequately powered to detect differences between treatment groups , an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups . Although a nonsignificant finding does not prove the null hypothesis , in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level . However , post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment . CONCLUSIONS A short-term course of family therapy appears to be as effective as a long-term course for adolescents with short- duration anorexia nervosa . However , there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment Dialectical Behavior Therapy for Binge Eating Disorder ( DBT-BED ) aims to reduce binge eating by improving adaptive emotion-regulation skills . Preliminary findings have been promising but have only compared DBT-BED to a wait-list . To control for the hypothesized specific effects of DBT-BED , the present study compared DBT-BED to an active comparison group therapy ( ACGT ) .  Men and women ( n=101 ) meeting DSM-IV BED research criteria were r and omly assigned to 20 group sessions of DBT-BED ( n=50 ) or ACGT ( n=51 ) . DBT-BED had a significantly lower dropout rate ( 4 % ) than ACGT ( 33.3 % ) . Linear Mixed Models revealed that posttreatment binge abstinence and reductions in binge frequency were achieved more quickly for DBT-BED than for ACGT ( posttreatment abstinence rate=64 % for DBT-BED vs. 36 % for ACGT ) though differences did not persist over the 3- , 6- , and 12-month follow-up assessment s ( e.g. , 12-month follow-up abstinence rate=64 % for DBT-BED vs. 56 % for ACGT ) . Secondary outcome measures revealed no sustained impact on emotion regulation . Although both DBT-BED and ACGT reduced binge eating , DBT-BED showed significantly fewer dropouts and greater initial efficacy ( e.g. , at posttreatment ) than ACGT . The lack of differential findings over follow-up suggests that the hypothesized specific effects of DBT-BED do not show long-term impact beyond those attributable to nonspecific common therapeutic factors Night eating syndrome ( NES ) is a form of disordered eating associated with evening hyperphagia ( overeating at night ) and nocturnal ingestions ( waking at night to eat ) . As with other forms of disordered eating , cognitive and behavioral treatment modalities may be effective in reducing NES symptoms . This review presents evidence for a variety of behavioral treatment approaches , including  behavioral therapy , phototherapy , behavioral weight loss treatment , and cognitive-behavioral therapy .  A more detailed overview of  cognitive-behavioral therapy  for NES is provided . All of these studies have been case studies or included small sample s , and all but one have been uncontrolled , but the outcomes of many of these approaches are promising . Larger r and omized controlled trials are warranted to advance NES treatment literature . With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5 ) as a “ Feeding or Eating Disorder Not Elsewhere Classified , ” more sophisticated , empirically-supported , behaviorally-based treatment approaches are much needed OBJECTIVE It is important to find ways to predict response to treatments as this may inform treatment planning . We examined rapid response in obese patients with binge eating disorder ( BED ) who participated in a r and omized placebo-controlled study of orlistat administered with cognitive behavioral therapy delivered by guided self-help ( CBTgsh ) format . METHODS Fifty patients were r and omly assigned to 12-week treatments of either orlistat+CBTgsh or placebo+CBTgsh , and were followed in double-blind fashion for 3 months after treatment discontinuation . Rapid response , defined as 70 % or greater reduction in binge eating by the fourth treatment week , was determined by receiver operating characteristic curves , and was then used to predict outcomes . RESULTS Rapid response characterized 42 % of participants , was unrelated to participants ' demographic features and most baseline characteristics , and was unrelated to attrition from treatment . Participants with rapid response were more likely to achieve binge eating remission and 5 % weight loss . If rapid response occurred , the level of improvement was sustained during the remaining course of treatment and the 3-month period after treatment . Participants without rapid response showed a subsequent pattern of continued improvement . CONCLUSION Rapid response demonstrated the same prognostic significance and time course for CBTgsh as previously documented for individual CBT . Among rapid responders , improvements were well sustained , and among non-rapid responders , continuing with CBTgsh ( regardless of medication ) led to subsequent improvements Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide . The seriousness of the disorder requires extensive knowledge of effective treatment options . However , evidence for treatment efficacy in this area is remarkably weak . A recent Cochrane review states that there is an urgent need for large , well- design ed treatment studies for patients with anorexia nervosa . The aim of this particular multi-centre study is to evaluate the efficacy of two st and ardized outpatient treatments for patients with anorexia nervosa :  focal psychodynamic ( FPT ) and cognitive behavioural therapy ( CBT ) . Each therapeutic approach is compared to a " treatment-as-usual " control group . Methods / Design 237 patients meeting eligibility criteria are r and omly and evenly assigned to the three groups – two intervention groups ( CBT and FPT ) and one control group . The treatment period for each intervention group is 10 months , consisting of 40 sessions respectively . Body weight , eating disorder related symptoms , and variables of therapeutic alliance are measured during the course of treatment . Psychotherapy sessions are audiotaped for adherence monitoring . The treatment in the control group , both the dosage and type of therapy , is not regulated in the study protocol , but rather reflects the current practice of established outpatient care . The primary outcome measure is the body mass index ( BMI ) at the end of the treatment ( 10 months after r and omization ) . Discussion The study design surmounts the disadvantages of previous studies in that it provides a r and omized controlled design , a large sample size , adequate inclusion criteria , an adequate treatment protocol , and a clear separation of the treatment conditions in order to avoid contamination . Nevertheless , the study has to deal with difficulties specific to the psychopathology of anorexia nervosa . The treatment protocol allows for dealing with the typically occurring medical complications without dropping patients from the protocol . However , because patients are difficult to recruit and often ambivalent about treatment , a drop-out rate of 30 % is assumed for sample size calculation . Due to the ethical problem of denying active treatment to patients with anorexia nervosa , the control group is defined as " treatment-as-usual".Trial registration Current Controlled Trials IS RCT Background : The aim of this study was to compare the immediate and longer-term effects of two cognitive behaviour therapy programmes for hospitalized patients with anorexia nervosa , one focused exclusively on the patients ' eating disorder features and the other focused also on mood intolerance , clinical perfectionism , core low self-esteem or interpersonal difficulties . Both programmes were derived from enhanced cognitive behaviour therapy ( CBT-E ) for e 
    Output:
    
The cognitive behavioral approach was the most effective treatment , especially for bulimia nervosa , binge eating disorder and the night eating syndrome .
For anorexia nervosa , the family approach showed greater effectiveness .
Other effective approaches were interpersonal psychotherapy , dialectic behavioral therapy , support therapy and self-help manuals .
Moreover , there was an increasing number of preventive and promotional approaches that addressed individual , family and social risk factors , being promising for the development of positive self-image and self-efficacy .
A abordagem cognitivo-comportamental foi o tratamento mais efetivo , principalmente para bulimia nervosa , transtorno da compulsão alimentar periódica e síndrome do comer noturno .
Para anorexia nervosa , a abordagem familiar demonstrou maior efetividade .