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24 - Strategies for secondary prevention

from Part V - Public health perspectives

Published online by Cambridge University Press:  02 December 2009

Brett McDermott
By
Greta Noordenbos
Edited by
Tony Jaffa
Brett McDermott
Affiliation:
University of Queensland
Greta Noordenbos
Affiliation:
Leiden University, Leiden, the Netherlands
Tony Jaffa
Affiliation:
Phoenix Centre, Cambridge
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Summary

Introduction

If those with anorexia nervosa (AN) or bulimia nervosa (BN) told their parents, teachers and general practitioners that they had an eating disorder and presented as motivated to change their eating behaviour, early detection would not be an issue. However, this is not the case. Most of those with eating disorders experience their slimming behaviour not as a problem but as a ‘solution’ for other problems such as having low self-esteem, a negative body image and feeling they are overweight. Their first success in losing weight generates higher self-esteem and a more positive attitude towards their body (Noordenbos, 1998). They are often very successful in hiding their eating disorder from others, sometimes even for years. This makes early detection by parents, teachers or general practitioners very difficult. The longer the duration of an ED, the more difficult it is to recover (Steinhausen et al., 1991). For this reason early diagnosis and early intervention are seen as important. Because these strategies start when a person already has an ED, we speak about secondary prevention.

Secondary prevention is an early intervention approach to seek out emerging manifestations of EDs, and by early intervention to reduce the likelihood of disease progression. As so many cases are girls between 12 and 18 years old who live with their parents and are in education, parents, teachers, peers and general practitioners may all play pivotal roles in secondary prevention. This chapter will describe the major issues including effectiveness of secondary prevention.

Keywords

eating attitudes testeating disorderspatientscreening programmessecondary preventionsecondary schools
Type
Chapter
Information
Eating Disorders in Children and Adolescents , pp. 305 - 316
Publisher: Cambridge University Press
Print publication year: 2006

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References

Anstine, D. & Grinenko, D. (2000). Rapid screening for disordered eating in college-aged females in the primary care setting. Journal of Adolescent Health, 26, 338–42.Google Scholar
American Psychiatric Association Work Group on Eating Disorders (2000). Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157 (suppl. 1), 20.
Beumont, P. J. V., Hay, P. & Beumont, R. O. (2003). Australian and New Zealand Clinical Practice Guideline for the Treatment of Anorexia Nervosa. Royal Australian and New Zealand College of Psychiatrists.
Burston, M. S., Gabel, L. L., Brose, J. A., & Monk, J. S. (1996) Detecting and treating bulimia nervosa: How involved are family physicians?Journal of American Board of Family Practitioners, 9, 241–8.Google Scholar
Bryant-Waugh, G. J., Lask, B. D., Shafran, R. L. & Fosson, A. R. (1992). Do doctors recognise eating disorders in children?Archives of Diseases in Childhood, 67, 103–5.Google Scholar
Carter, J. C., Olmsted, M. P., Kaplan, A. S.et al. (2003). A: Self-help for bulimia nervosa: a randomised controlled trial. American Journal of Psychiatry, 160, 973–8.CrossRefGoogle Scholar
Daaleman, C. J. (1991). More or less: Research on the prevalence of anorexia nervosa, bulimia nervosa, and obesity. (In Dutch.) Warnsveld: Rigg Oost Gelderland.
Dolan, B. & Gitzinger, I. (ed.) (1994). Why Women? Gender Issues and Eating Disorders.London: Athlone Press.
Fairburn, C. G. & Cooper, Z. (1993). The Eating Disorders Examination (12th edn). In Binge Eating: Nature, Assessment and Treatment, ed. Fairburn, C. G & Wilson, G. T.New York: Guilford Press, pp. 317–60.
Fennig, S. & Roe, D. (2002). Physical recovery in anorexia nervosa: is this the sole purpose of a child and adolescent medical-psychiatric unit?General Hospital Psychiatry, 24, 87–92.Google Scholar
Garner, D. M. & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of symptoms of anorexia nervosa. Psychological Medicine, 9, 273–9.Google Scholar
Geest, M. (2005). Parents' capacities to recognise an eating disorder in an early stage. Thesis. Leiden University, Leiden.
Gurney, V. W. & Halmi, K. A. (2001). Developing an eating disorders curriculum for primary care providers. Eating Disorders, 9, 97–107.Google Scholar
Hoek, H. W. (1991). The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care. Psychological Medicine, 21, 455–60.Google Scholar
Hoek, H. W., Bartelds, A. I. M., Bosveld, J. J. F.et al. (1995). Impact of urbanization on detection rates of eating disorders. American Journal of Psychiatry, 152, 1272–8.Google Scholar
Hugo, P., Kendrick, T., Reid, F., & Lacey, H. (2000). GP referral to an eating disorder service: why the wide variation?British Journal of General Practice, 50, 380–3.Google Scholar
King, M. B. (1989). Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12–18 months. Psychological Medicine, Monograph Supplement 14.Google Scholar
Kreipe, R. E. & Birndorf, S. A. (2000). Eating disorders in adolescents and young adults. Medical Clinics of North America, 84, 1027–49.CrossRefGoogle Scholar
Loeb, K. L., Wilson, G. T., Gilbert, J. S. & Labouvie, E. (2000). Guided and un-guided self-help for binge eating. Behaviour Research Therapy, 38, 259–72.Google Scholar
Morgan, J. F., Reid, F. & Lacey, J. H. (1999). The SCOFF questionnaire: assessment of a new screening tool for eating disorders. British Medical Journal, 319, 1467–8.Google Scholar
NICE Guidelines (2004). Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. Manchester: National Institute for Clinical Excellence.
Noordenbos, G. (1998). Eating disorders in primary care: early identification and intervention by general practitioners. In The Prevention of Eating Disorders, ed. Vandereycken, W. & Noordenbos, G.London: Athlone Press, pp. 214–29.
Noordenbos, G. & Vandereycken, W. (2005). Prevention of Eating Disorders. Mechelen:Kluwer.
Ogg, E. C., Millar, H. R., Pusztai, E. E. & Thom, A. S. (1997). General practice consultation patterns preceding diagnosis of eating disorders. International Journal of Eating Disorders, 22, 89–93.3.0.CO;2-D>CrossRefGoogle Scholar
Paxton, S. J. (1999). Peer relations, body image, and disordered eating in adolescent girls; implications for prevention. In Preventing Eating Disorders. A Handbook of Interventions and Special Challenges, ed. Piran, N., Levine, M. P. & Steiner-Adair, C.London: Brunner/Mazel, pp. 134–47.
Pritts, S. D. & Susman, J. (2003). Diagnosis of eating disorders in primary care. American Family Physician, 67, 297–304.Google Scholar
Raes, D. L., Schoemaker, C., Zipfel, S. & Williamson, D. A. (2001). Prognostic value of duration of illness and early intervention in bulimia nervosa: a systematic review of the outcome literature. International Journal of Eating Disorders, 30, 1–10.Google Scholar
Rathner, G. & Messner, K. (1993). Detection of eating disorders in a small rural town: an epidemiological study. Psychological Medicine, 23, 175–84.CrossRefGoogle Scholar
Schoemaker, C. (1997). Does early intervention improve the prognosis in anorexia nervosa? A systematic review of the treatment-outcome literature. International Journal of Eating Disorders, 21, 1–15.Google Scholar
Schoemaker, C. (1998). The principles of screening for eating disorders. In The Prevention of Eating Disorders, ed. Vandereycken, W. & Noordenbos, G.London: Athlone Press, pp. 187–213.
Steinhausen, H. C., Rauss-Masson, C. & Seidel, R. (1991). Follow-up studies of anorexia nervosa: a review of four decades of outcome research. Psychological Medicine, 21, 447–54.Google Scholar
Strober, M., Freeman, R. & Morrell, W. (1997). The long-term course of severe AN in adolescents: survival analysis of recovery, relapse and outcome predictors over 10–15 years in a prospective study. International Journal of Eating Disorders, 22, 339–60.Google Scholar
Vandereycken, W. (1993). Naughty girls and angry doctors: eating disorder patients and their therapists. International Review of Psychiatry, 5, 13–18.Google Scholar
Whitehouse, A. M., Cooper, P. J., Vize, C. V., Hill, C. & Vogel, L. (1992). Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. British Journal of General Practice, 42, 57–60.Google Scholar
Yanovski, S. Z. (1991). Bulimia nervosa: the role of the family physician. American Academy of Family Physicians, 44, 1231–8.Google Scholar

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