Treatment Results of Anorexia Nervosa and Bulimia Nervosa in a Residential Treatment Program

Abstract

Data on the effectiveness of residential treatment for patients with anorexia nervosa (AN) and bulimia nervosa (BN) are limited. We analyzed patient survey results at admission and discharge from Monte Nido Residential Treatment Program. Of 287 consecutive admissions, 80% (231) "graduated" (completed ≥ 30 days of treatment), and of these (all of whom gave consent), only patients with AN (N = 120) or BN (N = 95) were included (215 of 231, 93%) in this study. Analyses included a comparison of admission vs. discharge variables (paired t-tests) for each diagnosis. At each assessment, graduates completed the Eating Disorders Inventory-2 (EDI-2), the Beck Depression Inventory (BDI), and a structured eating disorder assessment questionnaire. For patients with AN, there were statistically significant improvements in mean BMI. In addition, for both AN and BN patients, there were statistically significant improvements in BDI scores, all 11 EDI-2 subscales, and frequencies of bingeing, vomiting, laxative abuse, chewing and spitting, stimulant abuse, and restricting behavior. The great majority of patients completing treatment showed significant improvement at discharge from intensive residential treatment.

A Narrative Review of Outcome Studies for Residential and Partial Hospital‐based Treatment of Eating Disorders

“…The residential treatment programmes discussed in this review (Brewerton & Costin, , Delinsky et al, ; Hoffart, Lysebo, Sommerfeldt, & Rø, ; Lowe et al, ; McHugh, ; Weltzin et al, ) are 24‐hour care facilities designed specifically for patients with ED that do not require continuous medical monitoring, all of which primarily used CBT and/or dialectical behaviour therapy in addition to other treatment modalities (e.g. interpersonal, psychodynamic, art therapy).…”

“…Two residential treatment studies included an adult‐only sample, and both revealed improvements across most outcome measures (Brewerton & Costin, , , Hoffart et al, ) (Table ). One of the studies evaluated patients with BN and reported a significant reduction in binge frequency, without a reduction in purge frequency, although specific scores were not provided, making the finding difficult to interpret (Hoffart et al, ).…”

Prognostic factors and outcome in anorexia nervosa: a follow-up study

“…Half of deaths were due to suicide, while other causes included alcohol abuse or medical consequences of marasmic malnutrition [5]. Short-term evaluations showed good outcomes ranging from 18 [6] to 42 % [7]. The 4-year or 5-year clinical recovery rate was higher and it was influenced by the duration of follow-up [8][9][10][11].…”

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

“…Residential treatment programmes have been found to be effective in the treatment of AN and BN both post-treatment and at 3–4 year follow-up [101,102]. Treatment for EDs may also take place within substance abuse treatment programmes, however not all such programmes are equipped with adequate knowledge or resources [93].…”