title: The diagnosis and treatment of eating disorders.
abstract: BACKGROUND
  Eating disorders are of major significance both in clinical medicine and in society at large. Anorexia and bulimia nervosa almost exclusively afflict young persons, severely impairing their physical and mental health. The peak ages for these diseases are in late adolescence and young adulthood; patients therefore suffer setbacks both in school and/or in their occupational careers. This scientifically based S3 guideline was developed with the intention of improving the treatment of eating disorders and motivating future research in this area.
  
  
  METHODS
  The existing national and international guidelines on the three types of eating disorders were synoptically compared, the literature on the subject was systematically searched, and meta-analyses on bulimia nervosa and binge-eating disorder were carried out. 15 consensus conferences were held, as a result of which 44 evidence-based recommendations were issued.
  
  
  RESULTS
  Anorexia and bulimia nervosa are diagnosed according to the ICD-10 criteria (International Classification of Diseases), binge-eating disorder according to those of the DSM (Diagnostic and Statistical Manual of Mental Disorders). Psychotherapy is the mainstay of treatment for all three disorders, and cognitive behavioral therapy is the form of psychotherapy best supported by the available evidence. The administration of selective serotonin reuptake inhibitors (SSRI) can be recommended as a flanking measure in the treatment of bulimia nervosa only. The evidence does not support any type of pharmacotherapy for anorexia nervosa or binge-eating disorder. Bulimia nervosa and binge-eating disorder can usually be treated on an outpatient basis, as long as they are no more than moderately severe; full-fledged anorexia nervosa is generally an indication for in-hospital treatment.
  
  
  CONCLUSIONS
  This guideline contains evidence- and consensus-based recommendations for the diagnosis and treatment of eating disorders. If strictly implemented, it should result in improved care for the affected patients.
authors: Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung, Universität des Saarlandes, 66421 Homburg, Germany. henning.madry@uks.eu
authors: Stephan
authors: S
authors: Herpertz
authors: Ulrich
authors: U
authors: Hagenah
authors: Silja
authors: S
authors: Vocks
authors: Jörn
authors: J
authors: von Wietersheim
authors: Ulrich
authors: U
authors: Cuntz
authors: Almut
authors: A
authors: Zeeck
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000592:standards*; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D011613:Psychotherapy / Q000592:standards*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors