Predictors of Positive Treatment Outcome in People With Anorexia Nervosa Treated in a Specialized Inpatient Unit: The Role of Early Response to Treatment

Abstract

Objective To investigate factors which predict positive treatment outcome in inpatients with anorexia nervosa (AN), particularly the role of early treatment response. Method 102 patients entering specialist inpatient treatment were assessed for eating disorder history, psychopathology, and motivation to change. Predictive factors assessed were: early treatment response defined as weight increase of at least 0.5–1 kg/week during the first 6 weeks of treatment (n=87), admission body mass index (BMI), onset age, chronicity, motivation to change, diagnosis, and previous hospitalization for AN. Positive treatment outcome was defined as achieving a BMI of 17.5 kg/m2 within an individual time frame. Results Logistic regression indicated that patients were 18 times more likely to reach positive treatment outcome if they met the National Institute for Health and Care Excellence weight guidelines within the first 6 weeks of hospitalization. Higher admission BMI was also found to predict positive treatment outcome. Discussion Higher entry BMI and early weight gain predict positive treatment outcome in individuals receiving specialist AN inpatient treatment. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Early Response to treatment in Eating Disorders: A Systematic Review and a Diagnostic Test Accuracy Meta‐Analysis

“…The characteristics of all AN studies are summarized in Tables 1 and 2. The same result was found with inpatient AN, where early weight gains at different time points during the first six weeks of treatment could predict remission (Hartmann et al, 2007;Wales et al, 2016). The same result was found with inpatient AN, where early weight gains at different time points during the first six weeks of treatment could predict remission (Hartmann et al, 2007;Wales et al, 2016).…”

“…Early weight gains in outpatient adolescents with AN were predictive of remission in studies using FBT (Doyle et al, 2010;Le Grange et al, 2014;Lock et al, 2006), adolescent focused therapy (Le Grange et al, 2014) and cognitive behavioural therapy adapted to eating disorders (CBT-E) (Raykos et al, 2013). The same result was found with inpatient AN, where early weight gains at different time points during the first six weeks of treatment could predict remission (Hartmann et al, 2007;Wales et al, 2016).…”

“…For the meta-analysis of AN results, only three studies (Le Grange et al, 2014;Madden et al, 2015;Wales et al, 2016) had the variables of interest. For the meta-analysis of AN results, only three studies (Le Grange et al, 2014;Madden et al, 2015;Wales et al, 2016) had the variables of interest.…”

“…The search resulted in a final selection of 24 articles for the qualitative synthesis. For the meta-analysis of AN results, only three studies (Le Grange et al, 2014;Madden et al, 2015;Wales et al, 2016) had the variables of interest. Two of these studies (Le Grange et al, 2014;Madden et al, 2015) performed two separate analyses using different definitions of early response, which were both examined.…”

“…Although only three studies could be included in the meta analysis, eight studies (Doyle et al, 2010;Hartmann, Wirth, & Zeeck, 2007;Le Grange et al, 2014;Lock et al, 2006;MacDonald et al, 2015;Madden et al, 2015;Raykos, Watson, Fursland, Byrne, & Nathan, 2013;Wales et al, 2016) included patients with AN. The characteristics of all AN studies are summarized in Tables 1 and 2.…”