Published on 5 April 2017

To mark World Health Day on April 7th, we took a look at a group of illnesses that are commonly underestimated: eating disorders. Current research aims to better adapt treatment to each patient.

Eating disorders such as bulimia or anorexia nervosa can be highly debilitating. They need to be treated as early as possible, before they become chronic. But how can care providers determine the best treatment? And how can treatment be adapted to individual patients? Working to answer these questions is Nathalie Godart, a child psychiatrist at the Centre for Research in Epidemiology and Public Health (CESP), an Inserm unit attached to Université de Versailles-Saint-Quentin en Yvelines, member of Université Paris-Saclay. Her research aims to assess the treatments available.

"We study patient outcomes at the end of treatment, after one year and after ten years. We analyze patient pathways to understand what helped them", explains the researcher. "These evaluations focus on the treatments as they are actually provided, given the daily reality of the health services."

Family therapies

Several factors contribute to the development or perpetuation of eating disorders, including relational factors, genetics and the environment. At puberty, the occurrence of stressful events can trigger psychiatric disorders, which can become chronic. But each patient has a different story, and care providers must try to understand what brought them there. It might be a traumatic event, depressive disorders... Treating the patient alone is not enough; family relationships must also be addressed, so treatment may involve the whole family.

"We have shown that by adding family therapy, the patient's progress is more positive than with individual treatment alone", says Dr Godart. She is currently evaluating different types of family therapy, involving either a single family or groups of families. The latter approach seems to be highly appreciated by the families themselves, and very effective. The objective is to understand which therapy to offer to each type of patient.

The project, dubbed Thérafam Best, is in its infancy: 150 families must be recruited (which will take two years), treatment carried out for one year, the outcomes monitored for six months to a year, and those outcomes then analyzed. So in four years' time, the hope is to be able to identify more effectively the profiles of patients who respond well to these new therapies. It is a welcome prospect for patients and their families, many of whom feel powerless when facing eating disorders.

More information: Centre for Research in Epidemiology and Public Health (CESP)