Addressing Habits in Anorexia Nervosa

by Eva Dorothea Zielke-Rössel née Zielke
Doctoral thesis
Date of Examination:2025-10-06
Date of issue:2025-10-23
Advisor:Prof. Dr. Timo Brockmeyer
Referee:Prof. Dr. Timo Brockmeyer
Referee:Prof. Dr. Marcella Woud
Persistent Address: http://dx.doi.org/10.53846/goediss-11559

 

 

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Abstract

English

Anorexia Nervosa (AN) is a mental disorder that affects up to 0.3% of men and 6.2% of women worldwide and places a significant burden on the individual, their social environment and the healthcare system. Although extensive research has examined potential mechanisms underlying the maintenance of the disorder, our understanding remains limited. This may account for the suboptimal outcomes of the psychotherapeutic approaches developed to date. The disordered eating- and weight-related behaviors characterizing AN often remain after treatment, which is closely associated with relapse. Regulating Emotions and Changing Habits (REaCH), a novel behavioral treatment, specifically targets these behaviors as a potentially maintaining mechanism and offers adaptive emotion regulation strategies in their stead if needed. The efficacy of REaCH was tested in a randomized controlled trial. 110 inpatients with AN were assigned to receive four weeks of either REaCH or supportive psychotherapy (active control condition) as an add-on to treatment as usual. Clinical outcome data was collected before and after treatment as well as at six-month follow-up. There were no significant differences between treatments regarding trajectories of weight, eating disorder pathology, food choice or habit strength. This may trace back to behavioral changes caused by the inpatient setting, extensive treatment as usual and short treatment duration. Difficulties in emotion regulation decreased more steeply in REaCH patients, pointing towards a potential benefit of REaCH. Implications for clinical practice and future research are discussed.
Keywords: Anorexia Nervosa; Cognitive Behavioral Therapy; Psychotherapy; Eating Disorder