title: Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders.
abstract: OBJECTIVE
  This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014.
  
  
  METHODS
  The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified.
  
  
  RESULTS
  In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to guide practice.
  
  
  CONCLUSIONS
  Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in AN, and research is urgently needed for all aspects of ARFID assessment and management.
  Associate Professor Susan Byrne, Dr Angelica Claudino, Dr Anthea Fursland, Associate Professor Jennifer Gaudiani, Dr Susan Hart, Ms Gabriella Heruc, Associate Professor Michael Kohn, Dr Rick Kausman, Dr Sarah Maguire, Ms Peta Marks, Professor Janet Treasure and Mr Andrew Wallis.
authors.affiliation: Members of the CPG Working Group School of Medicine and Centre for Health Research, University of Western Sydney, Australia School of Medicine, James Cook University, Townsville, Australia p.hay@uws.edu.au.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Hay
authors.affiliation: Members of the CPG Working Group Capital and Coast District Health Board, Wellington, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Chinn
authors.affiliation: Members of the CPG Working Group School of Pediatrics and Child Health, University of Western Australia, Perth, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.affiliation: Members of the CPG Working Group Eating Disorders Service, Sydney Children's Hospital Network, Westmead, Australia; School of Psychiatry, University of Sydney, Australia.
authors.forename: Sloane
authors.initials: S
authors.lastname: Madden
authors.affiliation: Members of the CPG Working Group Mental Health CSU, Austin Health, Australia; University of Melbourne, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Newton
authors.affiliation: Members of the CPG Working Group Department of Psychological Medicine, University of Otago at Christchurch, New Zealand.
authors.forename: Lois
authors.initials: L
authors.lastname: Sugenor
authors.affiliation: Members of the CPG Working Group School of Psychology and Centre for Eating and Dieting Disorders, University of Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Touyz
authors.affiliation: Members of the CPG Working Group Eating Disorders Service Royal Brisbane and Women's Hospital; University of Queensland, Brisbane, Australia.
authors.forename: Warren
authors.initials: W
authors.lastname: Ward
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001315:Australia; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D040261:Harm Reduction; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D009520:New Zealand; D009765:Obesity / Q000150:complications / Q000188:drug therapy; D000077403:Orlistat; D011570:Psychiatry; D012955:Societies, Medical; D000077236:Topiramate
chemical_list: D019440:Anti-Obesity Agents; D000928:Antidepressive Agents; D007783:Lactones; D000077236:Topiramate; D005632:Fructose; D000077403:Orlistat
keywords: Clinical Practice Guideline; eating disorders; evidence-based review