title: Treatment of patients with severe and enduring eating disorders.
abstract: OBJECTIVE
  Severe and enduring eating disorder is a new concept to the field that has potential to aid assessment and inform treatment. The aim of this review is to report recent developments in the conceptualization and treatment of people with severe and enduring eating disorder.
  
  
  RESULTS
  A systematic search identified 28 included papers. These addressed conceptualization of recovery and staging models (4 studies), clinical care, presentations and treatment experiences (7 studies), four new randomized controlled trials of treatment (9 studies), two open trials of novel approaches (2 studies) and problems of treatment resistance and involuntary care (6 studies).
  
  
  CONCLUSIONS
  The staging model appears to have validity and clinical utility in anorexia nervosa, but this is less clear in other eating disorders. Most literature on treatment, including new randomised controlled trials, is on underweight individuals, and there is a small literature on emerging psychological therapies that may improve outcomes. There is an expectation that with better treatment engagement, there may also be a reduced need for involuntary interventions.
authors.affiliation: aCentre for Health Research, School of Medicine, University of Western Sydney bSchool of Psychology, Faculty of Science, University of Sydney.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Hay
authors.forename: Stephen
authors.initials: S
authors.lastname: Touyz
mesh_terms: D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012720:Severity of Illness Index