Treatment-Resistant Eating Disorders

  • Youl-Ri Kim
  • Jione Kim


Eating disorders have a protracted course, with a median duration of 10 years. They also have a profoundly detrimental impact on social, vocational, psychological, and physical health; systematic reviews report recovery rates of less than 50%. Although there may be good responses to standard treatment in the early stages, once the illness has become severe and enduring, it becomes less responsive to any kind of treatment. A novel theory is that neuro-adaptive changes in response to the highly disturbed eating pattern cause treatment resistance. For individuals who are resistant to standard first-line treatment, it can be beneficial to use treatments that directly target some of the dysregulated circuits that maintain the disorder. These may circumvent the need to work only through top-down processes, which are disabled by the progressive neurological changes that ingrain the habits and fears that maintain the illness. New interventions targeting the neural changes reported in enduring eating disorders may improve the response to treatment.


Eating disorder Anorexia nervosa Bulimia nervosa Binge eating disorder Cognitive remediation therapy Oxytocin 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Youl-Ri Kim
    • 1
    • 2
  • Jione Kim
    • 2
  1. 1.Department of PsychiatrySeoul Paik Hospital, Inje UniversitySeoulSouth Korea
  2. 2.Institute of Eating Disorders and Mental HealthInje UniversityGimhaeSouth Korea

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