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Table 6 Recommendations for the management of eating disorders for people with higher weight: psychological therapy for adults

From: Management of eating disorders for people with higher weight: clinical practice guideline

Recommendation

Level of evidence

Psychological treatment should be offered as first-line treatment approach for bulimia nervosa or binge-eating disorder (BED)

A

Cognitive behaviour therapy (CBT) for an eating disorder either in standard form or therapist guided self-help should be considered as first-line treatment in adults with bulimia nervosa or BED

B

Other psychological treatments with evidence such as interpersonal psychotherapy (IPT) and dialectical behaviour therapy (DBT) should be considered as second-line treatment options in adults with bulimia nervosa or BED

B

Other feeding or eating disorder (OSFED), unspecified feeding or eating disorder (UFED) or subsyndromal eating disorders should be treated with treatment recommended for the most similar disorder

C

Consider using therapies utilising non-dieting principles and interventions to reduce disordered eating

D

Therapies with demonstrated efficacy for the treatment of anorexia nervosa* in general, that is cognitive behaviour therapy-enhanced (CBT-E), specialist supportive clinical management (SSCM), Maudsley model of outpatient treatment (MANTRA) and focal psychodynamic therapy (FPT) should be considered as treatment options

D

  1. NHMRC grades range: A. Body of evidence can be trusted to guide practice e.g., meta-analyses of randomised controlled trials (RCTs) low risk of bias; B. Body of evidence can be trusted to guide practice in most situations (RCTs or other controlled studies, low risk of bias); C. Body of evidence provides some support for recommendation(s) but care should be taken in its application (moderate risk of bias in trails); and D. Body of evidence is weak and recommendation must be applied with caution (high risk of bias in trails). Full criteria in Additional file 1: Appendix C
  2. * In this guideline, the ICD 11 terminology for anorexia nervosa is adopted rather than the DSM-5 criteria. That is, anorexia nervosa (code 6B80) is used as a broad term to include all people at all body weights and without specifying the underweight criterion (sub coded in ICD-11 as 6B80.0, anorexia nervosa with significantly low body weight). See “Background to eating disorders and how they occur” section for more detail.