Early weight gain in family-based treatment predicts greater weight gain and remission at the end of treatment and remission at 12-month follow-up in adolescent anorexia nervosa.
OBJECTIVE
To Identify whether early weight gain in family-based treatment (FBT) predicted greater weight and remission at end of FBT and 12-month follow-up.


METHODS
Eighty-two adolescents, with anorexia nervosa, participated in a randomized control trial comparing brief hospitalization for medical stabilization and hospitalization for weight restoration to 90% expected body weight (EBW) (1:1), followed by 20 sessions of FBT. Sixty-nine completed trial protocol. Receiver operating characteristic analyses were conducted investigating whether early weight-gain in FBT predicted outcomes at end of FBT and 12-month follow-up. Participants were analyzed according to their original randomization and as a combined set. Binary logistic regression was used to control for randomization arm effect in combined set analysis.


RESULTS
Weight gain greater than 1.8 kg at FBT Session 4 predicted greater %EBW (99.18 SD = 6.93 vs. 92.79 SD = 7.74, p < .05) and remission at end of FBT (46% vs. 11%, p < .05) and at 12-month follow-up (64% vs. 36%, p = .05). Binary logistic regression confirmed weight gain greater than 1.8 kg predicted remission (p < .05) while treatment arm randomization did not add significantly to the model.


CONCLUSIONS
Early weight gain has potential to distinguish likely responders in FBT from those who may need more intensive intervention to achieve remission offering the potential to improve outcomes.
Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead, Australia.|Discipline of Psychiatry, Faculty of Medicine, The University of Sydney, Australia.
Sloane
S
Madden
Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead, Australia.|Westmead Clinical School, The University of Sydney, Australia.
Jane
J
Miskovic-Wheatley
Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead, Australia.
Andrew
A
Wallis
Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead, Australia.|Discipline of Paediatrics, Faculty of Medicine, The University of Sydney, Australia.
Michael
M
Kohn
School of Medicine, University of Western Sydney, Australia.
Phillipa
P
Hay
School of Psychology, The University of Sydney, Australia.
Stephen
S
Touyz
D000293:Adolescent; D000856:Anorexia Nervosa / Q000628:therapy*; D001835:Body Weight; D005196:Family Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D012372:ROC Curve; D012074:Remission Induction; D016896:Treatment Outcome; D015430:Weight Gain
adolescent; anorexia nervosa; early weight gain; family‐based treatment; long‐term outcomes; outpatient treatment; treatment optimization