Priority 4 from the Eating Disorders (Netherlands) PSP

UNCERTAINTY: What is the most effective treatment (and order of treatment) for patients with an eating disorder and a co-morbid disorder? (JLA PSP Priority 4)
Overall ranking 4
JLA question ID 0039/4
Explanatory note Most patients with an eating disorder also have co-morbid disorders (affective disorder, PTSD, OCD, etc.). What to treat first, the eating disorder or the co-morbid disorder, or to treat both integrally, has never been tested in a clinical trial.
Evidence Huke V, Turk J, Saeidi S, Kent A, Morgan JF. Autism spectrum disorders in eating disorder populations: a systematic REVIEW. Eur Eat Disord Rev 2013; 21(5):345-351.
Health Research Classification System category Mental Health
Extra information provided by this PSP
Original uncertainty examples Why is there almost no treatment for patients with an eating disorder and comorbid disorder in the Netherlands? I see my eating disorder as a symptom, but for all specialized treatment (PTSD, Personality problems, etc.) require a minimal weight. This results in many years running in circles making it a hopeless and desperate mission. An eating disorder is a coping strategy due to a comorbid disorder. At least to me. I understand that severe underweight has priority, but the underlying problems are the cause. why isn’t it possible to treat both an eating disorder and comorbid disorder like trauma?
Submitted by Clinician x 12, Patients x 19, Carers x 1
PSP information
PSP unique ID 0039
PSP name Eating Disorders (Netherlands)
Total number of uncertainties identified by this PSP 77  
Date of priority setting workshop 3 June 2016