Clinical Care Guidelines


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General
Anorexia Nervosa
Binge Eating
Bulimia Nervosa
Avoidant/Restrictive Food Intake Disorder (AFRID)
Other Specified Feeding and Eating Disorders (OSFED)
Medical Management
Nutritional Approaches
Therapy Approaches
Psychopharmacology
Special Populations
Sports and EDs
Overlap of EDs and Obesity
Online Reources or Website
Research

 

General

Management of Restrictive Eating Disorders in Adolescents and Young Adults
Society for Adolescent Health and Medicine, 2015 
This position paper clarifies the role of the medical provider in diagnosing and treating eating disorders, proposes an evidence-based method for determining degree of malnutrition, and advocates for standardization of terminology and consistency in the use of terms referring to ideal, expected, or median body weight. 

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Eating Disorders
American Academy of Child and Adolescent Psychiatry, 2015
This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents. The Parameter focuses on the phenomenology of eating disorders, comorbidity of eating disorders with other psychiatric and medical disorders, and treatment in children and adolescents.

Practice Guideline for the Treatment of Patients with Eating Disorders
American Psychiatric Association, 2006 and 2012
This practice guideline provides an overview of eating disorders, including general information on their natural history, course, and epidemiology. It also provides a structured review and synthesis of the evidence that underlies the recommendations for treatment options. In 2012, a supplement was published to review new evidence and highlights salient developments. Additionally, a quick reference guide is also available.
 
Identification and Management of Eating Disorders in Children and Adolescents
American Academy of Pediatrics, 2010
This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. The range of treatment options, including pharmacotherapy, is described in this report.
 
Eating Disorders in Adolescents
Society for Adolescent Health and Medicine, 2003
This position statement represents a consensus from Adolescent Medicine specialists regarding the diagnosis and management of eating disorders in adolescents. This statement integrates evidence-based medicine, where available.

Eating Disorders in Children and Adolescents: State of the Art Review
Pediatrics, 2014
Despite their high prevalence, associated morbidity and mortality, and available treatment options, eating disorders (EDs) continue to be underdiagnosed by pediatric professionals. 

Eating Disorders
Pediatr Rev, 2016
For patients with moderate malnutrition, higher-calorie diets during refeeding may provide benefits, such as less initial weight loss, faster weight gain, and shorter hospitalization, without increasing the risk of refeeding syndrome. 
 
Anorexia Nervosa
 
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Anorexia Nervosa
American Psychiatric Association, 2013
The DSM-5 is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers of all orientations. The DSM-5: Anorexia Nervosa can be used by health professionals, social workers, and forensic and legal specialists to diagnose and classify mental disorders.
 
Refeeding Hypophosphatemia in Hospitalized Adolescents With Anorexia Nervosa
Society for Adolescent Health and Medicine, 2014 
Refeeding hypophosphatemia in hospitalized adolescents with anorexia nervosa is correlated with degree of malnutrition. Therefore, when initiating nutritional rehabilitation, clinicians should have a heightened awareness of the possibility of refeeding hypophosphatemia in severely malnourished patients
Binge Eating
 
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Binge Eating 
American Psychiatric Association, 2013
The DSM-5 is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers of all orientations. The DSM-5: Binge Eating can be used by health professionals, social workers, and forensic and legal specialists to diagnose and classify mental disorders.
 
Bulimia Nervosa
 
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Bulimia Nervosa
American Psychiatric Association, 2013
The DSM-5 is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers of all orientations. The DSM-5: Bulimia Nervosa can be used by health professionals, social workers, and forensic and legal specialists to diagnose and classify mental disorders.

Avoidant/Restrictive Food Intake Disorder (AFRID)
DSM-5  criteria

Other Specified Feeding and Eating Disorders (OSFED)


Medical Management 


Golden NH, Katzman DK, Sawyer SM, Ornstein RM, Rome ES, Garber AK, et al. Update on the medical management of eating disorders in adolescents. J Adolesc Health 2015;56(4):370-5. Available at http://www.jahonline.org/article/S1054-139X(14)00760-5/pdf
 
Dickstein LP, Franco KN, Rome ES, Auron M. Recognizing, managing medical consequences of eating disorders in primary care. Cleveland Clinic J Med 2014 April 81(4):255-263. PMID 24692444.
 
Katzman DK, Peebles R, Sawyer SM, Lock J, Le Grange D : The role of the pediatrician in family-based treatment for adolescent eating disorders: Opportunities and challenges.  Journal of Adolescent Health Oct 2013
  
Perez ME, Kapphahn CJ.  Gastrointestinal issues in adolescents with eating disorders.  Adolesc Med State Art Rev. 2016 Spring;27(1):155-76.

Strandjord SE, Sieke EH, Richmond M, Khadlikar A, Rome ES.  Medical stabilization of adolescents with nutritional insufficiency: A clinical care path. Eat Weight Disorders 2016; Sept 21(3):403-410, epub 2015 Nov 23. DOI 10.1007/s40519-015-0245-5. PMID 26597679

Nutritional Approaches

A Systematic Review of Approaches to Refeeding in Patients with Anorexia Nervosa
Int J Eat Disord, 2015 
Given the importance of weight restoration for recovery in patients with anorexia nervosa (AN), we examined approaches to refeeding in adolescents and adults across treatment settings.

Nutrition Issues and Concerns: Eating Disorders
Bright Futures, AAP, 2011
Pages 137–145 provide diagnostic criteria, screening, and assessment tools for children and adolescents.

Therapy Approaches

An Update on Evidence-based Psychosocial Treatments for Eating Disorders in Children and Adolescents
J Clin Child Adolesc Psychol, 2015
This review updates a previous Journal of Clinical Child and Adolescent Psychology review published in 2008. The recommendations in this review were developed after searching the literature including PubMed/Medline and employing the relevant medical subject headings
 
Advances in Psychotherapy for Children and Adolescents with Eating Disorders
Amer J Psychotherapy, 2009
There is a significant lag in the development of evidence based approaches for eating disorders in children and adolescents despite the fact that these disorders typically onset during these developmental periods.

Psychopharmacology

Golden NH, Attia E. Psychopharmacology of eating disorders in children and adolescents.Pediatr Clin North Am. 2011 Feb;58(1):121-38.

Special Populations

Strandjord, S.E., NG, H., Rome, E.S. Effect of treating gender dysphoria and anorexia nervosa in  transgender adolescent: Lessons learned. International Journal of Eating Disorders 2015; 48(7): 942 – 945.
 
Sieke EH, Rome ES. Eating disorders in children and adolescents: what does the gynecologist need to know? Curr Opin Obstet Gynecol 2016 Oct 29(5):381-92. PMID:27551880

Sports and EDs

Mountjoy M, Sundgott-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athletic Triad—Relative Energy Deficiency in Sport (RED-S). Br J Sports Med 2014, 48:491-497.
 
Weiss Kelly AK, Hecht S; Council on Sports Medicine and Fitness. The Female Athlete Triad. Pediatrics. 2016 Aug;138(2). pii: e20160922. doi: 10.1542/peds.2016-0922. Epub 2016 Jul 18
 
Ducher G, Turner AI, Kukuljan S, Pantano KJ, Carlson JL, Williams NI, De Souza MJ.  Obstacles in the optimization of bone health outcomes in the female athlete triad.  Sports Med. 2011 Jul 1;41(7):587-607. doi: 10.2165/11588770-000000000-00000.

Overlap of EDs and Obesity

Golden NH, Schneider  M, Wood C, AAP Committees on Nutrition, Adolescence, Obesity. Preventing obesity and eating disorders in adolescents. Pediatrics 2016:138(3):e20161649.

Online Reources or Websites

Eating Disorders: Critical Points for Early Recognition and Medical Risk Management in the Care of Individuals with Eating Disorders
Academy for Eating Disorders
Available in English
Available in 8 languages

DSM 5 Feeding and Eating Disorders
APA
Fact sheet

Third Party Links from FEAST-ED
Families Empowered and Supporting Treatment of Eating Disorder (FEAST-ED)
Printable resources, including family guide series, available online

9 Eating Disorder Myths Busted
NIMH
Cynthia Bulik, PhD, a NIMH grantee at the University of North Carolina, debunked nine myths about eating disorders at the at the NIMH Alliance for Research Progress Winter Meeting, February 7, 2014 in Rockville, MD.

Practice parameter for the assessment and treatment of children and adolescents with eating disorders
American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues
This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents.

Online Eating Disorder Screening 
National Eating Disorder Association, 2015 
NEDA partners with Screening for Mental Health, Inc. (SMH) to provide an online eating disorder screening tool. This website provides people with the option to take a free, anonymous self-assessment to gauge their risk of an eating disorder.

Eating Disorders Guidelines
Headspace, 2004–2014
This list of authoritative guidelines provides evidence-based information about the practical treatment of eating disorders.
 
Eating Disorders Guidance
National Institute for Health and Care Excellence, 2015
This resource by NICE, which gives national guidance and advice to improve health and social care,  provides guidance, guidelines, and advice for eating disorders as well as useful pathways to care.

Research

Forman SF, Grodin LF, Graham DA…Mammel KA (15/19)…Woods ER.  An eleven site national quality improvement project of adolescent medicine-based eating disorder programs: Predictors of weight outcomes at one year and risk adjustment analyses. Journal of Adolescent Health 2011. 49(6):594-600.

Ornstein RM, Rosen DS, Mammel KA. Callahan ST, Forman S, Jay MS, Fisher M, Rome E, Walsh BT. Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders. Journal of Adolescent Health 2013. 53(2):303-305.

Fisher MM, Rosen DS, Ornstein RM, Mammel KA, Katzman DK, Rome ES, Callahan ST, Malizio J, Kearney S, Walsh BT. Characteristics of Avoidant/ Restrictive Food Intake Disorder in children and adolescents: A “new disorder” in DSM-5. Journal of Adolescent Health 2014. 255:49-52. http://dx.doi.org/10.1016/j.jadohealth.2013.11.013 

Forman SF, McKenzie N, Hehn R, Monge MC, Kapphahn CJ, Mammel KA, Callahan ST, Sigel EJ, Bravender T,  Romano M, Rome ES, Robinson KA, Malizio JB, Fisher M, Rosen DS, Hergenroeder AC, Buckelew SM, Jay MS,  Lindenbaum J, Rickert VI, Garber A, Golden NH, Woods ER, National Eating Disorder Quality Improvement Collaborative.

Predictors of outcome at one year in adolescents with DSM-5 restrictive eating disorders: report of the National Eating Disorder Quality Improvement Collaborative. Journal of Adolescent Health. 2014. 55(6):750-756.. http://dx.doi.org/10.1016/j.jadohealth.2014.06.014.  

Monge MC, Forman SF, McKenzie NM, Rosen DS, Mammel KA, Callahan ST, Hehn R, Rome ES, Kapphahn CJ, Carlson  JL, Romano ME, Malizia JB, Bravender TD, Sigel EJ, Rouse MR, Graham DA, Jay MS, Hergenroeder AC, Fisher MM, Golden NH, Woods ER, National Eating Disorder Quality Improvement Collaborative. Use of psychopharmacologic medications in adolescents with restrictive eating disorders: analysis of data from the National Eating Disorder Quality Improvement Collaborative. Journal of Adolescent Health. 57(1):66-72, 2015.  Doi 10.1016/j.jadohealth.2015.03.021.

Hergenroeder AC, Weimann CM, Henges C, Dave A. Outcomes of adolescents with eating disorders from an adolescent medicine service at a large children’s hospital. Int J Adolesc Med Health 2015: 27(1): 49-56.

 

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