ABSTRACT
It was the best of times; it was the worst of times. One might use that phrase when examining the current state in the management of eating disorders, especially when management occurs in an inpatient or partial hospitalization setting. Inpatient treatments for eating disorders have evolved considerably, with increasing acceptance of a multidisciplinary approach, but still remain overly variable even with the current amount of evidence-based information. Earlier hospital-based treatments included one or several of the following: high doses of antipsychotic medications, tube feeding, nursing management, bed rest with a high-calorie diet, strict behavioral contingency management, hyperalimentation, and a variety of medical regimes (1-5). The literature also describes a variety of variably successful psychological interventions to restore weight among persons with an eating disorder. Several controlled trials of behavior therapy have been reported (6-8). Strict behavioral interventions have recently been criticized as being narrow minded, leading to short-term compliance but frequent relapse. Long-term outcome studies suggested that weight restoration alone by strictly medical or behavioral methods was a temporary phenomenon, which at times produced negative effects (9).
