title: Minimizing and treating chronicity in the eating disorders: a clinical overview.
abstract: OBJECTIVE
  The purpose of this article is to review the available literature regarding treatment and management of eating disorder patients who fail to change over protracted periods of time.
  
  
  METHODS
  Literature was reviewed pertaining to approaches to promoting change in treatment-resistant cases and the treatment of chronic eating disordered individuals.
  
  
  RESULTS
  Although there are a number of clinical perspectives on the treatment of chronic eating disorder patients, fundamental studies defining the concept of "chronicity" and standardized treatment approaches do not exist. Empirical studies of chronic cases are needed, given the absence of investigation of maintenance factors in chronic eating disorders and evidence-based approaches for treatment. An integrative and practical clinical protocol is provided.
  
  
  CONCLUSIONS
  The results of this review suggest that a significant number of eating disorder patients display a chronic course, which is poorly understood. Treatments for these individuals are not based on evidence-based findings.
authors.affiliation: University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA. stephenw@medicine.nodak.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Wonderlich
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: Tricia Cook
authors.initials: TC
authors.lastname: Myers
authors.forename: Kelly
authors.initials: K
authors.lastname: Kadlec
authors.forename: Kim
authors.initials: K
authors.lastname: Lahaise
authors.forename: Lorraine
authors.initials: L
authors.lastname: Swan-Kremeier
authors.forename: Julie
authors.initials: J
authors.lastname: Dokken
authors.forename: Marnie
authors.initials: M
authors.lastname: Lange
authors.forename: Janna
authors.initials: J
authors.lastname: Dinkel
authors.forename: Michelle
authors.initials: M
authors.lastname: Jorgensen
authors.forename: Linda
authors.initials: L
authors.lastname: Schander
mesh_terms: D002908:Chronic Disease; D001068:Feeding and Eating Disorders / Q000628:therapy*; D006801:Humans; D017211:Treatment Failure