Eating Disorders Treatment: An Integrative Model by Means of Narrative Counseling, Motivational Interviewing, and Traditional Approaches

Abstract

The devastating effect of eating disorders on health has led to their inclusion among the priority mental illnesses for children and adolescents identified by the World Health Organization (World Health Organization [WHO], 2005). Crude mortality rates for anorexia nervosa have ranged from 0 to 8% across studies, with a cumulative mortality rate of 2.8% (9 deaths for 318 patients followed an average of 11 years) (Keel & Brown, 2010). The overall mortality rate for anorexia nervosa is five times that of the same aged population in general, the highest of all psychiatric illnesses. Death from natural causes, such as cardiac arrhythmia and infection, is four times greater, and death from unnatural causes, such as suicide, eleven times greater than expected. Risk of successful suicide is particularly high: thirty-two times that in the same aged general population (Centre for Excellence in Eating Disorders, Facts and Figures, 2005). About 50% of anorexia nervosa patients/victims return to a normal body weight within six months of treatment. 25% maintain a low but stable weight, and the remaining 25% remain chronically ill or die (CEED, 2005). 76% of patients enrolled in a randomized controlled trial achieved remission by five-year follow-up (Keel & Brown, 2010).