Article

Rate of Inpatient Weight Restoration Predicts Outcome in Anorexia Nervosa

Laureate Institute for Brain Research, Tulsa, Oklahoma 74136, USA.
International Journal of Eating Disorders (Impact Factor: 3.13). 05/2009; 42(4):301-5. DOI: 10.1002/eat.20634
Source: PubMed

ABSTRACT

To examine weight restoration parameters during inpatient treatment as predictors of outcome in anorexia nervosa (AN).
Adolescent and adult females admitted for inpatient eating disorder treatment were recruited for an ongoing longitudinal study. This analysis examined several weight restoration parameters as predictors of clinical deterioration after discharge among participants with AN.
Rate of weight gain was the only restoration parameter that predicted year 1 outcome. Clinical deterioration occurred significantly less often among participants who gained >or=0.8 kg/week (12/41, 29%) than those below this threshold (20/38, 53%) (chi(2) = 4.37, df = 1, p = .037) and remained significant after adjustment for potential confounders.
Weight gain rate during inpatient treatment for AN was a significant predictor of short-term clinical outcome after discharge. It is unclear whether weight gain rate exerts a causal effect or is rather a marker for readiness to tolerate weight restoration and engage in the recovery process.

0 Followers
 · 
14 Reads
  • Source
    • "Our results raise questions of whether weight gain during inpatient treatment is more attributable to the structured environment, enhanced motivational support, and unit supervision of eating and weight gain than the patient's level of body distortion, general symptoms, and personality problems. In several studies, weight gain and BMI at discharge have been shown to predict the outcome at followup for AN patients (Kaplan et al., 2009; Lund et al., 2009; Steinhausen, Grigoroiu-Serbanescu, Boyadjieva, Neumarker, & Winkler, 2008). Kaplan et al. investigated the factors predicting maintenance of weight gain after initial treatment and found that the psychopathological factors assessed were of limited use (Kaplan et al., 2009). "

    Full-text · Dataset · Jul 2014
  • Source
    • "Although the field has identified numerous pre- and post-treatment predictors of outcome among individuals with AN, there are two gaps in the literature which, if addressed, might help to explain why AN patients fare worse than those with other eating disorders. First, there is a scarcity of research on the processes that occur for AN patients during treatment [16,22,23]. Most treatment studies assess patients at two discrete time points (i.e., pre and post). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Individuals with Anorexia Nervosa (AN) are renowned for their poor short- and long-term treatment outcomes. To gain more insight into the reasons for these poor outcomes, the present study compared patients with AN-R (restrictive subtype), AN-BP (binge-purge subtype), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS) over 12 weeks of specialized eating disorders treatment. Eighty-nine patients completed the Eating Disorder Examination- Questionnaire (EDE-Q) and various measures of psychosocial functioning at baseline, and again after weeks 3, 6, 9, and 12 of treatment. Results Multilevel modeling revealed that, over the 12 weeks, patients with AN-BP and AN-R had slower improvements in global eating disorder pathology, shape concerns, and self-compassion than those with EDNOS and BN. Patients with AN-BP had slower improvements in shame, social safeness (i.e., feelings of warmth in one’s relationships), and received social support compared to those with AN-R, BN, and EDNOS. Conclusions These findings support the need for more effective and comprehensive clinical interventions for patients with AN and especially AN-BP. Results also highlight not-yet studied processes that might contribute to the poor outcomes AN patients often face during and after treatment.
    Full-text · Article · Jan 2014 · International Journal of Eating Disorders
  • Source
    • "Our results raise questions of whether weight gain during inpatient treatment is more attributable to the structured environment, enhanced motivational support, and unit supervision of eating and weight gain than the patient's level of body distortion, general symptoms, and personality problems. In several studies, weight gain and BMI at discharge have been shown to predict the outcome at followup for AN patients (Kaplan et al., 2009; Lund et al., 2009; Steinhausen, Grigoroiu-Serbanescu, Boyadjieva, Neumarker, & Winkler, 2008). Kaplan et al. investigated the factors predicting maintenance of weight gain after initial treatment and found that the psychopathological factors assessed were of limited use (Kaplan et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated changes and predictors during inpatient treatment of 55 adult in a transdiagnostic sample of patients with eating disorders. Patients were assessed at admission and discharge with the Body Attitude Test (BAT), Symptom Check List 90 Revised, Circumplex of Interpersonal Problems, Body Mass Index (BMI) and Eating Disorder Inventory 2 (EDI-2). Significant changes were found in all measures. Regression analyses showed that BAT changes during treatment were the strongest predictor of EDI-2 changes. No predictors of changes in BMI were found. Improvement of body image is important for the efficacy of inpatient treatment.
    Full-text · Article · Jul 2012 · Eating disorders
Show more