Trajectories and predictive factors of weight recovery in patients with anorexia nervosa completing treatment. A latent class mixed model approach

Abstract

BackgroundTreatment of anorexia nervosa (AN) sometimes requires hospitalisation, which is often lengthy, with little ability to predict individual trajectory. Depicting specific profiles of treatment response and their clinical predictors could be beneficial to tailor inpatient management. The aim of this research was to identify clusters of weight recovery during inpatient treatment, and their clinical predictors.MethodsA sample of 181 inpatients who completed a treatment programme for AN was included in a retrospective study. A latent class mixed model approach was used to identify distinct weight‐gain trajectories. Clinical variables were introduced in a multinomial logistic regression model as predictors of the different classes.ResultsA four‐class quadratic model was retained, able to correctly classify 63.7% of the cohort. It encompassed a late‐rising, flattening, moderate trajectory of body mass index (BMI) increase (class 1), a late‐rising, steady, high trajectory (class 2), an early‐rising, flattening, high trajectory (class 3) and an early‐rising, steady, high trajectory (class 4). Significant predictors of belonging to a class were baseline BMI (all classes), illness duration (class 2), and benzodiazepine prescription (class 3).ConclusionPredicting different kinetics of weight recovery based on routinely collected clinical indicators could improve clinician awareness and patient engagement by enabling shared expectations of treatment response.

A Collaborative and Therapeutic Approach for Measuring the Correct Body Weight in People with Anorexia Nervosa

“…For example, a recently published study has found that a higher BMI was associated with more severe ED psychopathology, more depressive symptoms, anxiety sensitivity, experiential avoidance, and lower mindfulness in patients across the whole spectrum of restrictive, binge-purge, and atypical AN [13]. Furthermore, recent research indicates that body weight at the start of inpatient treatment as well as weight gain kinetics during inpatient therapy for AN might help to predict treatment outcomes, improve clinical decision-making, and manage expectations of patients and clinicians [14]. Thus, a collaborative and more accurate way of measuring body weight might improve the clinical formulation and the decision-making process and lead to better treatment success and a more pleasant treatment experience in people with AN.…”