The case for warming as an adjunctive treatment for AN patients is based on strong experimental evidence gathered from
research on animals with Activity-Based Anorexia (ABA). We posit that the beneficial effect of heat results, at least in
part, from heat blocking the vicious cycle that hyperactivity plays on AN. Hyperactivity decreases caloric intake by
interfering with feeding and increases energy expenditure through excess motor activity which in turn increases
emaciation that further strengthens anorexic thinking.
Recently, Specialist Supportive Clinical Management (SSCM) has once again been found to be equally efficacious in comparison to the Maudsley model of anorexia nervosa treatment for adults (MANTRA) and an enhanced version of cognitive behavior therapy treatment (CBT-E), even though: ‘It was hypothesized that CBT-E and MANTRA would be superior to SSCM in terms of weight gain and eating disorder psychopathology as they both focus on specific maintaining processes’ (Byrne et al. 2017, p. 2824). It is interesting to stress that in this study the developers of the specialized brand-name treatments were involved in the design and monitoring of the study, which guaranteed that the appropriate version of the treatment was used in this randomized clinical trial.
Disparate treatments, placebos, and treatments as usual have similar efficacy for anorexia nervosa. A parsimonious dissection of the this issue with Occam’s razor will necessarily challenge the assumptions on which the diagnosis of anorexia nervosa is based. One such assumption is the role of body-image disturbance, which became a key diagnostic symptom of anorexia nervosa in the literature almost five decades ago, long before any empirical evidence was gathered about this symptom. Body-image disturbance is far more represented among therapists and in the hypotheses of researchers than in the minds of patients. Concerns about body image might not stem exclusively from the patient’s underlying motives for refusing food, but might be in part a by-product of the “psychiatrist zeal in searching out motives”, as first recognised before the inclusion of body-image disturbance in the conceptualisation of anorexia nervosa. Body-image disturbance and weight and shape concerns are the result of an acculturation process spread through the therapeutic milieu and the mass media.
Gutierrez, E., Carrera, O., Vazquez, R. Birmingham. CL.. Climate might be considered as a isk factor for anorexia nervosa? An hypothesis worth other look. in press, Eating Behaviors
GUTIERREZ, E., CARRERA, O. Psychological therapies in Anorexia Nervosa: On the wrong track. British Journal of Psychiatry,2013, 202:384.
Último articulo en prensa en el International Journal of Eating Disorders.