Germany Releases Revised Guidelines for the Diagnosis and Treatment of Eating Disorders

Reston, VA, January 28, 2021

Germany has released a second edition¹ of their S3 guidelines, “Diagnosis and Treatment of Eating Disorders”. Similar to the first edition² published in 2010, the second edition includes chapters on epidemiology, diagnostics, the therapeutic relationship, Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), physical sequelae, and methodology. Based on greater recognition of their prevalence during the first half of life, two new eating disorder categories: “other specified feeding or eating disorder” (OSFED; which includes “night eating syndrome”) and “avoidant/restrictive food intake disorder” (ARFID),  have been added to replace the old category of “eatings disorders not otherwise specified” (EDNOS). The inclusion of these two disorders is consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)³. Therapy guidelines were also updated, as current rates of remission for AN and BN are low^4-5.

The guidelines for both children and adults were updated following a two-day consensus conference held in Germany in November 2017. The meeting was led by the Association of the Scientific Medical Societies in Germany (AWMF), and was attended by patient spokespersons and representatives from the following professional societies: the German Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (GKJP), the Section for Clinical Psychology and Psychotherapy of the German Psychological Society (DGPs), the German Society for Psychosomatic Medicine and Medical Psychotherapy (DGPM), the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), and the German College of Psychosomatic Medicine (DKPM). Professor Stephan Herpertz, lead author of the guidelines, described the democratic and rigourous process that took place when revising the guidelines: “Each guideline has to be discussed and there is voting. If there is a discrepancy, then there has to be a big discussion to come to agreement”.

The guidelines were revised based on both scientific (e.g., meta-analyses of treatment evaluations⁶⁾ and practice-based recommendations, with the aim of helping patients and health professionals make decisions relating to diagnosis and treatment.

The German guidelines aid with consistency across international guidelines for the diagnosis and treatment of eating disorders, and may facilitate greater collaboration between researchers and practitioners across the world. The updated version of the S3 “Diagnosis and Treatment of Eating Disorders” guidelines can be viewed here.

References

¹ German Society for Psychosomatic Medicine and Medical Psychotherapy (DGPM), German Society for Eating Disorders (DGESS), German Society for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy (DGKJP). German Association for Psychiatry, Psychotherapy and Neurology (DGPPN), German College for Psychosomatic Medicine (DKPM), German Psychological Society (DGPS; 2020). Joint German Guideline “Diagnosis and treatment of eating disorders”.

² Association of the Scientific Medical Societies. [Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF] (2010). S3 Leitlinie Diagnostik und Therapie von Essstörungen [S3 Guidelines of Diagnosis and Treatment of Eating Disorders]. http://www.awmf.org/leitlinien/detail/ll/051-026.html

³ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Association.

⁴ Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011) Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731.

⁵ Hoang, U., Goldacre, M., & James, A. (2014) Mortality following hospital discharge with a diagnosis of eating disorder: national record linkage study, England, 2001-2009. International Journal of Eating Disorders, 47(5), 507-15.

⁶ Hilbert, A., Petroff, D., Herpertz, S., Pietrowsky, R., Tuschen-Caffier, B., Vocks, S., & Schmidt, R. (2019). Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder. Journal of Consulting and Clinical Psychology, 87(1), 91-10.

ABOUT

The Academy for Eating Disorders (AED) is an international professional association committed to the leadership in eating disorders research, education, treatment, and prevention. The goal of the AED is to provide global access to knowledge, research, and best treatment practice for eating disorders. For additional information, please contact Elissa Myers at (703) 626-9087 and visit the AED website at www.aedweb.org.

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