Beating Bulimia, from a Distance
Researcher Studies Effectiveness of Therapy via Telemedicine for Rural Patients with Eating Disorders; Major NIH Grant Funds Project
How do you reach patients who suffer from eating disorders, and who live in rural areas, with the kind of psychotherapeutic care they need, care that is generally not available in most smaller towns in the Upper Midwest?
A new form of therapy, using telemedicine, has been tested by a team of UND medical school researchers and shown to be a very viable, productive means of treating these patients, especially those with bulimia nervosa, a serious eating disorder characterized by binge-eating followed by self-induced purging (vomiting).
Headed by James Mitchell, M.D., professor and chair of clinical neuroscience, Fargo, the researchers have demonstrated that “televised cognitive behavior therapy” is just as effective, and acceptable to patients, as the traditional care provided by a therapist who is physically in the same room with the patient.
“We need to think of creative ways to help women and girls become more happy with their bodies regardless of their size.” |
Mitchell, who also serves as president of the Neuropsychiatric Research Institute (NRI), has received a major grant from the National Institutes of Health (NIH) to continue a project aimed at helping patients in rural areas who suffer from eating disorders.
In the first phase of the study, also funded by NIH, the researchers compared cognitive behavior therapy (CBT) delivered via telemedicine and CBT delivered in person, involving patients in rural and smaller urban areas in North Dakota and northwestern Minnesota, Mitchell said. The two methods “were equally effective and acceptable to patients, with good maintenance of treatment effects at one-year follow-up.”
CBT is a highly structured form of counseling, with the patient given specific readings and assignments, he noted. “It’s like a class as much it’s like a therapy session.”
The new five-year, $2.5 million grant from NIH’s National Institute of Mental Health funds the next phase of the study which involves comparing variations in telemedicine-delivered CBT to unsupervised self-help.
“This additional study allows us to pursue our goal of developing delivery systems for effective and cost-effective intervention for patients in rural areas, where specialized treatments are usually not available,” Mitchell said.
The therapy takes four months, with follow-up visits at six and 12 months, he said. Because the project is federally sponsored, he and his colleagues are able to provide care at no charge to participating patients.
Bulimia nervosa (BN) is a prevalent form of eating disorder that affects two to three percent of girls and women in late adolescent and young adulthood, he said. “The age of onset is usually 18... Most people who need this therapy don’t get it.”
Studies reveal that five to six percent of girls and young women “have symptoms but not full-blown bulimia nervosa,” he said. “Most practicing psychotherapists who treat patients with BN have not been adequately trained to deliver the care that has emerged as a recommended standard.
“Therefore there appears to be a growing discrepancy between what is being used experimentally in academic centers and recommended by researchers in the field and what is available in the community,” he said.
Internationally recognized for his work in eating disorders, such as anorexia nervosa, bulimia nervosa and obesity, Mitchell is the author of numerous books in his field of study and has written extensively for publication in scientific journals.
The recipient of numerous awards and honors, he was named in 2003 as a McCann Scholar, a prestigious honor given to a select few outstanding mentors in medicine in the United States. At UND, he holds the NRI/Lee Christoferson, M.D., Chair in Neuroscience and the Chester Fritz Distinguished Professorship, the latter is the highest faculty honor bestowed by UND.
Pamela D. Knudson
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