title: Mandating weekly weight gain in a day treatment program for eating disorders.
abstract: OBJECTIVE
  We examined differences in treatment outcome associated with a "self-directed"- versus "external-incentive"-based day treatment protocol for individuals with eating disorders (EDs) with below normal body mass index. The self-directed protocol recommended a weekly 500 g weight gain, but allowed participants freedom to gain weight at their own rate; the "external-incentive" protocol required a minimum weight gain of 500 g/week as a requirement for staying in the program.
  
  
  METHODS
  Weight outcome was available for 49 individuals who were treated with the recommended weight gain protocol, and 40 individuals who were treated with the required weight gain protocol.
  
  
  RESULTS
  Post-treatment weight was significantly higher in patients treated in the required weight gain protocol compared to those treated in the recommended weight gain protocol. All patients, regardless of which program they completed, showed improvements in the measures of eating-disorder and comorbid-psychiatric symptoms.
  
  
  CONCLUSIONS
  This study demonstrated the benefits of an alteration in protocol that required no additional financial or human resources. Further studies are needed to validate the effectiveness of various day treatment protocol parameters.
authors.affiliation: Eating Disorders Program, Douglas University Institute, Montreal, Quebec, Canada; Psychiatry Department, McGill University, Montreal, Quebec, Canada.
authors.forename: Lea
authors.initials: L
authors.lastname: Thaler
authors.forename: Samantha
authors.initials: S
authors.lastname: Wilson
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Coelho
authors.forename: Juliana
authors.initials: J
authors.lastname: Mazanek Antunes
authors.forename: Mimi
authors.initials: M
authors.lastname: Israel
authors.forename: Howard
authors.initials: H
authors.lastname: Steiger
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009042:Motivation; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
keywords: day treatment; eating disorders; weight gain