In a Chicago Tribune article yesterday, writer Judith Graham painted a pretty bleak picture of treatment options and outcomes for anorexia. One of the main jumping off points for her report was a study that appeared this month in JAMA regarding the efficacy of fluoxetine, commonly known as Prozac, in treating recovering anorexics (see our coverage here).
The coverage was factually pretty accurate, but the problem was that it painted a bleak picture of failure and untreatable anorexics, which doesn't necessarily jive with the facts on the ground. Dr. Mada Hapworth has treated many people who struggle with eating disorders over the course of her career, and she has written about the topic here at Anxiety, Addiction and Depression Treatments. As she points out, the JAMA study presents some very nice research, but does so over a very limited topic.
"The problem is that just because Prozac doesn't work, that doesn't mean all drugs are going to be failures," Dr. Hapworth said, pointing out that when treating depression it is often necessary to try several medications to find the one that best suits the patient and their symptoms. "Sometimes psychopharmacology isn't a science, but more of an art. Therapists need to work with the patient to find a treatment that will be suitable," she added.
Past research has shown that antidepressants can be used to treat recovering anorexics, that is those that have gotten their weight back to a normal level. So while the JAMA study no doubt calls Prozac's use into question, it was itself small (as most eating disorder studies tend to be) and needs further confirmation.
The writer also declares that therapy is of "little help," which is just false. As the University of Chicago program director was quoted in the story, and Dr. Hapworth confirmed, there are many treatments that can prove effective in treating eating disorders and specifically anorexia. Family therapy, Dr. Hapworth noted, is perhaps the best option, but is often the most difficult to schedule. And as they mentioned, early detection and preventative care remains the most effective because as the behaviors become more set, they become harder to treat for a number of reasons. Ms. Graham's piece often makes anorexia seem like a death sentence. Clearly this is not the case, and only through persistence and continued research and exploration will we be able to better help those who struggle with the disease.
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