Complementary and Integrative Medicine and Eating Disorders in Youth: Traditional Yoga, Virtual Reality, Light Therapy, Neurofeedback, Acupuncture, Energy Psychology Techniques, Art Therapies, and Spirituality

In ED, the standard of care requires interdisciplinary collaboration and the adoption of several treatment modalities.99,100 With the exception of lisdexamfetamine (Vyvanse) for BED, medication has not yielded significant effects.1 Hence, the importance of examining complementary and integrative modalities that can elevate the efficacy of standard treatment. Several other modalities have been used historically for wellness for centuries, like traditional yoga and acupuncture. These interventions have been recognized and are now being researched. Others include spirituality/religion, the arts (art therapy, music therapy, DMT, and drama therapy), and massage. Music ther-apy seems to hold the most promise due to its ability to elicit issues not normally shared with the therapeutic team. Massage has only two small RCTs; interestingly, both showed physiologic changes with improvements in depression, anxiety, and eating pathology. It has been challenging to prescribe these modalities as standard-ized interventions. The different delivery of that these modalities have made it difficult to do comparative studies. Outcomes are difficult to study due to the individual nature of how these modalities are experienced. However, it is worth harnessing the benefits of these modalities when people have a particular interest in them. With younger generations, technology-based interventions have been shown to in-crease retention in treatment and have good efficacy with core symptoms of EDs.39 The best thing about VR is its versatility of it. It increased the ability to tolerate stress and cope with situations involving food. It is very good for eating and body image exposure and has allowed patients to continue treatment during COVID quarantines. In addition, VR is accessible, and other modalities can be utilized via this platform, such as BLT101 EMDR and biofeedback102 EMDR has limited research but addresses negative memories/trauma associated with body image and eating, and use in VR and in-person was not statistically different.103 BLT can be a safe adjunctive therapy for ED core symptomatology and depressive symptoms.73 Other technologies such as NF continue to be expensive and are often used more as a last resort. Overall, the trends in ED treatment are the combination of old methods with modern delivery modalities, which have shown to be effective and evidence-based to support their use.