Do end of treatment assessments predict outcome at follow-up in eating disorders?
OBJECTIVE
To examine the predictive value of end of treatment (EOT) outcomes for longer term recovery status.


METHODS
We used signal detection analysis to identify the best predictors of recovery based on outcome at EOT using five different eating disorder samples from randomized clinical treatment trials. We utilized a transdiagnostic definition of recovery that included normalization of weight and eating related psychopathology.


RESULTS
Achieving a body weight of 95.2% of expected body weight by EOT is the best predictor of recovery for adolescents with anorexia nervosa (AN). For adults with AN, the most efficient predictor of weight recovery (BMI > 19) was weight gain to greater than 85.8% of ideal body weight. In addition, for adults with AN, the most efficient predictor of psychological recovery was achievement of an eating disorder examination (EDE) weight concerns score below 1.8. The best predictor of recovery for adults with Bulimia Nervosa (BN) was a frequency of compensatory behaviors less than two times a month. For adolescents with BN, abstinence from purging and reduction in the EDE restraint score of more than 3.4 from baseline to EOT were good predictors of recovery. For adults with binge eating disorder, reduction of the Global EDE score to within the normal range (<1.58) was the best predictor of recovery.


CONCLUSIONS
The relationship between EOT response and recovery remains understudied. Utilizing a transdiagnostic definition of recovery, no uniform predictors were identified across all eating disorder diagnostic groups.
Department of Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
James
J
Lock
W Stewart
WS
Agras
Daniel
D
Le Grange
Jennifer
J
Couturier
Debra
D
Safer
Susan W
SW
Bryson
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D056912:Binge-Eating Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome; D055815:Young Adult
predictors; recovery; transdiagnostic