title: Moderators of weight gain in the early stages of outpatient cognitive behavioral therapy for adults with anorexia nervosa.
abstract: OBJECTIVE
  Treatments for anorexia nervosa have relatively low levels of effectiveness. This prospective study examines the impact of patients' characteristics on their early responses to cognitive behavioral therapy (CBT) for anorexia nervosa.
  
  
  METHODS
  Patients' eating attitudes, body mass index, and comorbid characteristics at the outset of treatment were used to predict drop-out and changes in weight across the first 10 sessions of CBT. Forty anorexic patients (28 full syndrome and 12 atypical cases--body mass index range = 12.8-18.4) entered CBT for anorexia nervosa.
  
  
  RESULTS
  Early drop-outs (N = 6) had relatively low levels of anxiety at the beginning of therapy, but there were no other moderators. Weight gain was slower in the 6th to 10th sessions among patients with relatively unhealthy eating attitudes (restraint and shape concerns). Higher levels of anxiety at the start of treatment were associated with poorer weight gain across these first 10 sessions.
  
  
  CONCLUSIONS
  Early anxiety levels should be attended to closely in CBT for anorexia nervosa, with low levels indicating a high risk of drop-out and a greater need for engagement and motivational work, and high levels, indicating that clinicians should work explicitly with the patient on anxiety reduction techniques in order to enhance their level of early weight gain.
authors.affiliation: Central and North West London NHS Foundation Trust, London, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lockwood
authors.forename: Lucy
authors.initials: L
authors.lastname: Serpell
authors.forename: Glenn
authors.initials: G
authors.lastname: Waller
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D001828:Body Image; D001835:Body Weight / Q000502:physiology; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D009042:Motivation; D010045:Outpatients; D010352:Patient Dropouts; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology*