Abstract
BackgroundIndividuals 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.ResultsMultilevel 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.ConclusionsThese 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.
Highlights
Individuals with Anorexia Nervosa (AN) are renowned for their poor short- and long-term treatment outcomes
We found that diagnosis predicted baseline Eating Disorder Examination- Questionnaire (EDE-Q) global scores, F (3, 76) = 2.93, p < .05, eating concerns, F (3, 76) = 3.48, p < .05, weight concerns, F (3, 76) = 2.78, p < .05, and shape concerns, F (3, 76) 4.38, p < .01, but not restraint, F (3, 76) = 1.0, n.s
There was no effect of diagnosis on baseline received social support, shame, or self-compassion, indicating that patients across the four diagnostic groups did not differ from one another in these variables at the start of the study
Summary
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. Individuals with Anorexia Nervosa (AN) typically fare worse than those with other eating disorders, and it is unclear why [1,2,3]. Patients with AN are more likely to drop out of treatment prematurely and less likely to experience sustained symptom remission following treatment [4,5,6,7,8,9] They face a risk of mortality that tends to be higher than that of other psychiatric groups [10,11,12]. With regards to pre-treatment predictors, certain characteristics of the disorder, such as binge-purge behaviours and a
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