Table 2.
Study characteristics, programme details and outcomes.
| References | N (%F) | Study design | Mean age in years (SD, range) | Diagnosis | ∧Admis. criteria/referral source | ∧Aims/disch. criteria | Therapeutic model(s) | Treatment intensity | Mean length of stay (SD, range) | Baseline data mean (SD) | Discharge outcome data mean (SD) | Follow-up outcome data months (n, % baseline sample) & mean (SD) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| California, USA | ||||||||||||
| Brown et al. (31) | 99 (97%) | Uncontrolled case series | 15.8 (1.56, 11–19) | AN (100%) | W (<85% EBW) | WG (100% EBW), AWT, R | Family focused [FBT, DBT] | 6–10 h/d 6 days/wk |
92.9 days (NR, 29–281) | %EBW: 79.2 (NR) EDE-Q(G): 3.1 (NR) |
%EBW: 94.2 (NR)***
EDE-Q(G): 1.8 (NR)*** |
6 months (n = 41, 41%) %EBW: 94.3 (NR) ns§ EDE-Q(G): 1.8 (NR) ns§(FU weight self-report) |
| Parks et al. (32) | 29 (%NR) | Qualitative | 16.6 (2.2, 12–21) [all <18 during treatment] | AN-R (34%) AN-BP (21%) BN (27.8%) OSFED (17.2%) |
NR | NR | Family focused [FBT, DBT] | 10 h/d 6 days/wk |
NR | NR | NR | NR |
| Reilly et al. (33) | 59 (49%) | Sample description | 10 (NR, 6–12) | ARFID (100%) | MS, S | AWT, G | Family focused [FBT, DBT] | 6 h/d 5 days/wk |
NR | %IBW: 85.4 (7.0) [SE group] 86.8 (8.5) [FOC group] 82.8 (5.2) [LA group] ED symptoms NR |
NR | NR |
| Reilly et al. (34) | 265 (93%) | Uncontrolled case series | 15.7 (1.71, 11–21) | AN-R (58%) AN-BP (13%) BN (14%) ARFID (6%) BED (1%) OSFED (7%) |
MS, S, NG | AWT, I, R | Family focused [FBT, DBT] | 6–10 h/d 6 days/wk |
73.1 days (NR, NR) | %EBW: 87.5 (10.3) [AN group] EDE-Q(G): 3.2 (1.8) |
%EBW: 99.7 (9.1)*** [AN group] EDE-Q(G): 2.0 (1.6)*** |
6 months (n = 93, 35%) %EBW: 98.2 (11.1) ns§ [AN group] EDE-Q(G): 2.0 (1.6) ns§ 12 months (n = 77, 29%) %EBW: 99.1 (10.1) ns§ [AN group] EDE-Q(G): 1.7 (1.6) ns§ (FU weight self-report) |
| Georgia, USA | ||||||||||||
| Freudenberg et al. (35) | 151 (100%) | Uncontrolled case series) | 22.5 (8.4, 13–57) | AN (49%) BN (51%) |
NR | NR | Non-family focused [CBT, Psychod., DBT, MI, ACT, FT] | 6 days/wk | 13.7 weeks (9.5, 2–57) [AN group] 13.1 weeks (10.4, 1–45) [BN group] | 99.4lbs (11.0, NR) [AN group] EDI-2: 7.6 (4.0) [AN group] 9.6 (6.8) [BN group] |
108.9lbs. (13.1, NR)** [AN group] EDI-2: 3.2 (2.9)** [AN group] 3.9 (3.7)** [BN group] |
NR |
| Schaffner and Buchanan, (36) | 77 (100%) | Uncontrolled case series | 21.4 (6.7, 14–40) | Eating disorders | NR | NR | Non-family focused [CBT, Psychod., DBT, Art therapy, social skills, FBT for ado. AN] | 3.5–7.5 h/d 6 days/wk |
12.8 weeks (8.5, 1-43) | 117.7lbs (33.3) EDI-2: 8.1 (3.8) |
124.5lbs (30.1)***
EDI-2: 3.05 (2.8)*** |
NR |
| Schaffner and Buchanan, (36) | 196 (98%) | Uncontrolled case series | 22.6 (7.8, 13–51) | AN (%NR) BN (%NR) EDNOS (%NR) [purging: 81.5% bingeing: 77.4%] |
NR | G | Non-family focused [CBT, BT, Art therapy, social skills] | 3.5–7.5 h/d 6 days/wk |
13.6 weeks (10.3, 1–60) | Weight NR EDI-2: 8.4 (3.9) |
Weight NR EDI-2: 3.5 (3.2)*** |
NR |
| Illinois, USA | ||||||||||||
| Hayes et al. (37) | 1,200 (93%) | Uncontrolled case series | 21.2 (10.8, 11–68) | AN (19%) BN (12%) BED (12%) OSFED (56%) |
S | NR | Non-family focused [CBT-E, DBT, ACT] | 6 h/d 5 days/wk |
19.2 days (12.4, NR) | zBMI: = −1.39 (0.95) [ <20 yrs, AN group] BMI: 17.5 (2.2) [>20 yrs, AN group] EDE-Q(G): 3.5 (1.5) |
zBMI: −0.089 (0.84)*** [ <20 yrs, AN group] BMI: 18.6 (2.0)*** [>20 yrs, AN group] EDE-Q(G): 2.3 (1.5)*** |
NR |
| Michigan, USA | ||||||||||||
| Berona et al. (38) | 102 (92%) | Uncontrolled case series | 16.4 (2.9, 11–24) | AN (77%) “subthreshold AN” (23%) | NR | NR | Family focused [FBT] | 6 h/d 5 days/wk |
27.8 days (4.7, NR) | BMI: 16.3 (1.4) [rapid gain grp] 17.4 (2.1) [mod. gain grp] 18.1 (2.5) [slow gain grp] EDE-Q(G): 2.9 (1.6) |
Lbs. gained +16.7 (3.4) [rapid gain grp] +8.6 (3.0) [mod. gain grp] +3.1 (2.2) [slow gain grp] EDE-Q(G): NR |
No FU |
| Homan et al. (39) | 113 (92%) | Uncontrolled case series | 14.4 (1.7, NR) [ado.] 19.6 (1.57, NR) [YA] | AN (79%) EDNOS (21%) |
MS | AWT | Family focused [FBT, CBT, DBT, CRT] | 6 h/d 5 days/wk |
21.8 days (12.9, NR) | BMI: 17.6 (2.2) EDEQ (global): 2.9 (1.8) |
Means NR (Authors report both adolescents and young adults show improvements in symptoms during DP) | 3 months (n, % NR) DP led to symptom improvement that was maintained at follow up for adolescents, but not for young adults. Means NR. |
| Hoste (40) | 28 (89%) | Uncontrolled case series | 16.6 (3.5, 8–24) | AN (71%) EDNOS-R (29%) |
PP/SD | WG (90–95% EBW) | Family focused [FBT] | 6 h/d 5 days/wk |
31.7 days (13.9, 13–76) | %EBW: 82.1 (9.6) EDE-Q(G): 3.2 (1.9) %EBW: 81.6 |
%EBW: 93.1 (6.5) *** [completers (n = 21)] EDE-Q(G): 1.9 (1.4)** |
No FU |
| Rienecke (41) | 53 (%NR) | Uncontrolled case series | “adolescents” (M, sd, range NR) | AN (67.9%) ARFID (13.2%) OSFED (18.9%) |
PP/SD | AWT | Family focused [FBT] | 6 h/d 5 days/wk |
25 days (10.9, NR) | NR | NR [no change in parental marital satisfaction during DP treatment] | No FU |
| Rienecke (42) | 87 (91%) | Uncontrolled comparison study (dropout [n = 19] vs. completers [n = 68]) | 14.1 (1.7, 10–18) [ado.] 19.6 (1.6, 19–24) [YA] | AN (100%) | PP/SD | AWT | Family focused [FBT] | 6 h/d 5 days/wk |
25.1 days (12.9, 1–74) | %EBW: 84.96 (7.7) [ado.] BMI: 17.54 (1.7) [YA] EDE-Q(G): NR |
Completers: %EBW: 99.2 (10.7) [ado.] BMI: 19.8 (1.0) [YA] Dropouts: %EBW: 89.1 (10.3) [ado.] BMI: 18.9 (1.6) [YA] EDE-Q(G): NR |
No FU |
| Rienecke (42) | 3 (33%) | Case study | 10.7 (3.1, 8–14) | ARFID (100%) | PP/SD | AWT | Family focused [FBT] | 6 h/d 5 days/wk |
20 days (1.7, 19–22) | BMI: 15.4 (1.3) ED measure NR |
BMI: 16.7 (1.5) ED measure NR |
No FU |
| Rienecke and Ebeling (43) | 26 (89%) | Uncontrolled case series | 15.5 (2.2, 12–19) | AN (46%) EDNOS-R (54%) |
PP/SD | AWT | Family focused [FBT] | 6 h/d 5 days/wk |
27.6 days (10.9, NR) | %EBW: 88.1 (12.6) EDE-Q(G): 2.3 (1.6) |
%EBW: 101.5 (14.8)***
EDE-Q(G): 2.0 (1.4) (ns) |
No FU |
| Rienecke and Richmond (44) | 26 (96%) | Uncontrolled case series | 16.6 (3.2, 11–22) | AN (77%) EDNOS-R (23%) |
PP/SD | WG (90–2% EBW), AWT | Family focused [FBT] | 6 h/d 5 days/wk |
28.2 days (14.6, NR) | %EBW: 80.9 (6.2) EDE-Q(G): 3.3 (1.7) |
%EBW: 92.8 (5.1)***
EDE-Q(G): 1.8 (1.4)** |
3 months (n = 25–26, 96–100%) %EBW: 97.7 (5.0)**§ [n = 25] EDE-Q(G): 1.5 (1.5) ns§ [n = 26] (FU weight self-report) |
| Rienecke et al. (45) | 56 (93%) | Uncontrolled case series | 15.8 (2.9, 12–24) | AN (73%) EDNOS-R (27%) |
PP/SD | WG (90% EBW), AWT | Family focused [FBT] | 6 h/d 5 days/wk |
27.6 days (12.1, NR) | %EBW: 82.6 (7.4) EDE-Q(G): 3.4 (1.7) |
93.0% EBW (5.2)***
EDE-Q(G): 2.2 (1.4)*** |
No FU |
| Smith et al. (46) | 51 (94%) | Uncontrolled case series | 13.94 (NR, 9–17) | AN-R (70.6%) AN-BP (7.8%) A-AN (21.6%) |
PP/SD | WG (90–95% EBW), AWT | Family focused [FBT, CBT, DBT, CRT] | 6 h/d 5 days/wk |
35.6 days (11.94, NR) | %EBW: 82 (6) EDE-Q(G): 2.4 (1.7) |
%EBW: 93 (3)**
EDE-Q(G): 2.1 (1.5) (ns) |
No FU |
| Van Huysse et al. (47) | 70 (91%) | Uncontrolled case series | 15.5 (2.6, 10–19) | AN (100%) | PP/SD | WG (>95%), R | Family focused [FBT] | 6 h/d 5 days/wk |
29.6 days (10.6, 10–74) | %mBMI: 80.0 (5.7) EDE-Q(G): 2.0 (1.5) |
%mBMI: 91.9 (5.9)**
EDE-Q(G): 1.6 (1.3)* |
No FU |
| Missouri, USA | ||||||||||||
| Fewell et al. (48) | 423 (95%) | Uncontrolled case series | 23.7 (9.5, 11–60) | AN (62.2%) BN (15.6%) BED (2.4%) ARFID (1.2%) OSFED (6.6%) EDNOS (12%) |
NR | NR | Non-family focused [CBT, DBT, art therapy, music therapy, some FT] | NR | 49.5 days (27.1, 7-120 days) | BMI: 17.7 (0.2) [AN group] EDE-Q(G): 4.0 (1.5) |
BMI: 20.4 (0.2)*** [AN group] EDE-Q(G): 2.6 (1.5)*** | 12 months (n = 65, 15%) BMI: 20.61 (0.18) ns§ [AN group] EDE-Q(G): 2.9 (1.4)*§ (sig. increase from discharge to FU) |
| New Jersey, USA | ||||||||||||
| Huryk et al. (49) | 326 (%NR) | Uncontrolled comparison study (FBT-DP [n = 138] vs. non-FBT-DP [n = 188]) | 15.7 (2.1) [FBT-DP] 15.9 (2.1) [DP] Range total sample 8–21 |
AN (74%) BN (6%) OS/UFED (20%) ARFID (0.6%) |
NR | NR | Family focused [FBT, DBT, yoga, art, body image group] | 40 h/wk | 29.4 days (18.9) [FBT-DP] 33.0 days (14.6) [non-FBT-DP] total: 31.44 (16.39, NR) | %EBW: 82.9 (9.5) [FBT-DP] 87.0 (13.4) [non-FBT-DP] (84.6 (11.5) [total sample]) |
NR | No FU |
| New York, USA | ||||||||||||
| Dancyger et al. (50) | 82 (100%) | Uncontrolled comparison study (orthodox [n = 8] vs. modern [n = 74] Jews) | 16.0 (2.3) [orthodox group] 18.0 (2.5) [other] Range total sample 12–18 |
AN (63%) BN (20%) EDNOS (17%) |
PP/SD | G, AWT | Non-family focused [Integrative MDT approach] | 8 h/d 5 days/wk |
15.3 weeks (NR) [orthodox group] 10.4 weeks (NR) [modern group] |
%IBW: 94% (NR) [orthodox group] 92% (NR) [modern group] EDI-2(DT): 18.2 (5.2) [orthodox group] 14.3 (6.2) [modern group] |
%IBW 102% (NR) [orthodox group] 95% (NR) [modern group] EDI-2(DT): NR |
No FU |
| Dancyger et al. (50) | 82 (98%) | Uncontrolled case series | 17.9 (NR, 12–30) | AN (63.4%) BN (19.5%) EDNOS (17.1%) |
PP/SD | AWT | Non-family focused [Integrative MDT approach] | 8 h/d 5 days/wk |
15 weeks (16.9, NR) | %IBW: 87 (NR) [AN group] 93 (NR) [EDNOS group] 112 (NR) [BN group] EDI-2(DT): 15.4 (5.7) [AN group] 16.8 (5.7) [EDNOS group] 10.5 (6.5) [BN group] |
%IBW (sd NR): 91 [AN group] 98 [EDNOS group] 110 [BN group] EDI-2(DT): NR |
No FU |
| deGraft-Johnson et al. (51) | 198 (96%) | Uncontrolled case series | 17.7 (NR, 12+) | AN (53%) BN (8%) EDNOS (39%) |
PP/SD | AWT | Non-family focused [Integrative MDT approach] | 8 h/d 5 days /wk |
2.6 weeks (NR, 1–8) | 17.8 BMI (NR) | Kg: +0.95 [all] Kg: +1.15 [AN group] (BMI, sd NR) |
No FU |
| Wisotsky et al. (52) | 65 (100%) | Uncontrolled case series | 18 (3.3,12-27) | AN (65%) BN (18%) EDNOS (17%) |
NR | NR | Non-family focused [Integrative MDT approach] | 8 h/d 5 days/wk |
Mean NR (range 4–394 days) | NR | NR | No FU |
| Ohio, USA | ||||||||||||
| Martin-Wagar et al. (53) | 87 (92%) | Uncontrolled case series | 14.9 (NR, 12–18) | AN-R (71%) AN-BP (29%) |
PP | WG (>95%EBW), AWT | Family focused [FBT, CBT, DBT] | 8 h/d 5 days/wk |
7.4 weeks (4.7, 0–22.5) | %EBW: 82.83 (6.89) EDE-Q(G): 3.3 (1.8) |
%EBW: 98.0 (9.3) EDE-Q(G): NR |
No FU |
| Pennsylvania, USA | ||||||||||||
| Bustin et al. (54) | 30 (87%) | Uncontrolled case series | 12.8 (2.0, NR) “adolescents” | AN (33%) BN (7%) EDNOS (60%) |
NR | NR | Family focused [As per Ornstein et al. (57)] | 6-8 h/d 5 days/wk |
33.3 days (9.9, NR) | %IBW: 86 (NR) ChEAT (total): 24.7 (NR) |
%IBW: 96 (NR)***
ChEAT (total): 11.8 (NR)*** |
No FU |
| Bryson et al. (55) | 62 (89%) | Uncontrolled comparison study (ARFID vs. AN in DP with FU) | 11.4 (1.6) [ARFID group] 14.1 (1.5) [AN group] (range 7–17) |
AN (68%) ARFID (32%) |
S | AWT | Family focused [FBT, CBT, BT, ERP] | 8.5 h/d 5 days/wk |
Weeks: 6.8 (3.7) [ARFID group] 11.2 (5.3) [AN group] |
%mBMI: 84.9 (7.9) [ARFID group] 81.6 (8.9) [AN group] ChEAT (total): 17.6 (14.2) [ARFID group] 9.2 (11.9) [AN group] |
%mBMI:***
94.0 (8.2) [ARFID group] 95.5 (6.9) [AN group] ChEAT (total):*** 33.6 (16.4) [ARFID group] 12.2 (11.5) [AN group] |
30 months (n = 59, 95%) %mBMI: 95.1 (8.6) ns§ [ARFID group] 97.9 (11.1) ns§ [AN group] ChEAT (total): 5.8 (3.2)*§ [ARFID group] 9.0 (8.7)*§ [AN group] |
| Lane-Loney et al. (56) | 81 (74%) | Uncontrolled case series | 10.9 (2.2) [fear group] 13.1 (2.1) [appetite group] 11.5 (2.0) Co-primary group] |
ARFID (100%) | MS, PP | AWT | Family focused [FBT, CBT] | 5 days/wk | Days: 28.5 (11.0, NR) [FOC group] 22.9 (8.4, NR) [LA group] 29.9 (15.9, NR) [co-primary] |
%mBMI: 88.3% (15.03) [FOC group] 85.6 [10.9] [LA group] 79.9 (89.6) [co-primary group] ChEAT(OC): 7.3 (3.7) [FOC group] 7.1 (5.5) [LA group] 7.35 [co-primary group] |
%mBMI:**
97.3 (14.3) [F0C group] 95.3 (10.1) [LA group] 79.9 (89.6) [co-primary group] ChEAT(OC)**: 3.7 (4.0) [FOC group] 5.5 (4.0) [LA group] 4.2 (3.3) [co-primary group] |
No FU |
| Nicely et al. (57) | 173 (92%) | Descriptive | 13.5 (2.03, 7.2–16.9) | AN (53.8%) BN (11.6%) ARFID (22.5%) OS/UFED (12.1%) |
NR | NR | Family focused | 6-8 h/d 5 days/wk |
NR | %mBMI 87.1 (13.0) [ARFID group] 82.6 (9.2) [AN group] 108.1 (19.5) [BN] 93.2 (6.8) [OS/UFED group] ChEAT (total): 14.9 (2.1) [ARFID group] 27.5 (17.3) [rest of group] |
n/a | No FU |
| Ornstein et al. (58) | 30 (87%) | Uncontrolled case series | 12.8 (2, 8–16) | AN (33%) BN (7%) EDNOS (60%) |
S, PP | AWT | Family focused | 6-8 h/d 5 days/wk |
33.3 days (13.4, NR) | %IBW: 86 (10) ChEAT (total): 20 (NR) |
%IBW: 96% (7)***
ChEAT (total): 9.0 (NR)*** |
No FU |
| Ornstein et al. (59) | 130 (92%) | Uncontrolled comparison study (ARFID vs other EDs in DP) | 13.5 (2.1, 7–17) | AN (52.3%) BN (11.5%) ARFID (24.6%) OS/UFED (11.5%) |
S, PP | AWT | Family focused [FBT, CBT, BT] | 6-8 h/d 5 days/wk |
Weeks in DP: 7.0 (3.4, NR) [ARFID group] 11.9 (4.2) [AN group] 8.9 (3.6) [BN group] 9.2 (3.7) [OS/UFED group] |
%mBMI: 86.2 (10.0) [ARFID group] 82.9 (8.0) [AN group] 110.7 (21.1) [BN group] 93.4 (7.2) [OS/UFED group] ChEAT (total): 14.2 (12.8) [ARFID group] 30.5 (14.8) [AN group] 39.6 (19.1) [BN group] |
%mBMI:***
95.5 (8.0) [ARFID group] 95.2 (5.5) [AN group] 109.2 (17.4) [BN group] 98.4 (5.2) [OS/UFED group] ChEAT (total):*** 9.8 (10.5) [ARFID group] 11.6 (10.5) [AN group] 13.9 (13.0) [BN group] 14.0 (12.0) [OS/UFED group] |
No FU |
| 25.0 (18.6) [OS/UFED group] | ||||||||||||
| Zickgraf et al. (60) | 83 (76%) | Descriptive | 11.38 (NR, 8–17) | ARFID (100%) | S | NR | Family focused [FBT, CBT, BT, ERP] | 8.5 h/d 5 days/wk |
NR | %MBW 95.2 (28.7) [SE group] 83.5 (11.4) [LA group] (16.1) [FOC group] 80.1 (9.6) [co-primary] Selective: 95.23%mBMI (28.71) ED sympt. NR |
n/a | No FU |
| Wisconsin, USA | ||||||||||||
| Bean et al. (61) | 16 (88%) | Uncontrolled comparison study (FBT-DP [n = 9] vs. non-FBT-DP [n = 7]) | 15.4 (2.6, 12–20) | AN-R (100%) | NR | AWT | Family focused [FBT, CBT, IPT] | 2–6 h/d 5 days/wk |
Weeks: 11.6 (5.6, 5–24) [FBT-DP] 11 weeks (5.2, 4–18) [non-FBT-DP] |
BMI: 16.9 (NR) [FBT-DP] 16.2 (NR) [non-FBT-DP] EDE-Q(G): 3.8 (NR) [FBT-DP] 2.6 (NR) [non-FBT-DP] |
BMI:*
19.6 (NR) [FBT-DP] 19.2 (NR) [non-FBT-DP] EDE-Q(G): 1.6 (NR)* [FBT-DP] 1.3 (NR) (ns) [non-FBT-DP] |
No FU |
| Canada | ||||||||||||
| Girz et al. (62) | 17 (100%) | Uncontrolled case series | 16.1 (1.0, 13–18) | AN-R (24%) BN (35%) EDNOS-R (35%) EDNOS-BP (6%) |
PP/SD, MS | AWT | Family focused [FBT] | 5 days/wk | 149.76 days (30.34, NR) | %IBW: 88.0% (NR) EDI-3(DT): 49.2 (12.6) |
%IBW: 16/17 reached 100% EDI-3(DT): 31.1 (13.1)* |
No FU |
| Grewal et al. (63) | 65 (94%) | Uncontrolled case series (completers [n = 38] vs. non-completers [n = 27]) | 15.6 (1.4, 13–18) | AN-R (60%) AN-BP (14%) BN (11%) BED (3%) EDNOS (12%) |
W (> 80% GW), SD | WG (100% GW) | Family focused [FBT] | 5 days/wk | 200.4 Days (109.8, 42–517) | %GW: 91.7 (6.1) ED sympt. measure NR |
%GW: 101.8 (7.7)* [restrictive group only] ED sympt. measure NR |
No FU |
| Henderson et al. (64) | 65 (100%) | Uncontrolled case series | 15.0 (1.3, 11–17) | AN (64%) BN (10%) EDNOS (26%) |
SD | WG (>19 BMI), AWT | Family focused [FBT] | 10 h/d 5 days /wk |
14.8 weeks (6.0, NR) | BMI: 18.7 (2.4) EDI-2(DT): 16.1 (6.0) |
BMI 20.5 (2.0)***
EDI-2(DT): 11.6 (7.4)** |
6 months (n = 43–61, 66–95%) BMI 19.8 (2.2) ***∧ [n = 61] EDI-2(DT): 11.72 (7.3)***∧ [n = 43] |
| Ngo and Isserlin (65) | 49 (100%) | Uncontrolled comparison study (completers [n = 14] vs. failures [n = 35]) | 15.3 (1.2, 13–17) | AN-R (69.4%) AN-BP (30.6%) |
NR | WG (>92.5% IBW) | Non-family focused [CBT, art therapy, may have FT] | 8 h/d 4 days/wk |
81.9 days (61.7, NR) | %IBW: 84.1 (4.5) ED sympt. Measure NR |
%IBW: 89.9 (5.4) ED sympt. Measure NR |
No FU |
| Pennell et al. (66) | 24 (96%) | Uncontrolled case series | 15.4 (1.3, 13–17) | AN-R (42%) AN-BP (25%) BN (4%) EDNOS (21%) ARFID (8%) |
PP/SD, S | G, AWT | Family focused [FBT, DBT] | 6–10 h/d 5 days/wk |
8.8 weeks (6.6, 2–35) | %IBW: 94.8 (8.2) ED sympt. Measure NR |
IBW: 99.5 (8.0)88 5/7 abstinent from binge-purge behaviors |
No FU |
| Spain | ||||||||||||
| Lazaro et al. (67) | 160 (94%) | Uncontrolled comparison study (AN-r [n = 116] vs. BN-r [n = 44]) | 15.5 (1.2, 13–18) | AN (59%) BN (18%) EDNOS (23%) |
PP/SD, S | AWT | Non-family focused [CBT, BT] | 6.5 h/d 5 days/wk |
3 months (NR) | BMI: 18.3 (1.2) [AN-rd group] 20.3 (3.3) [BN-rd group] EAT-40: 49.9 (26.0) [AN-rd group] 50.9 (18.1) [BN-rd group] |
BMI: 19.2 (NR) [AN-rd group] 20.6 (NR) [BN-rd group] EAT-40 NR |
No FU |
| Serrano-Troncoso et al. (68) | 77 (94%) | Uncontrolled case series | 14.4 (1.6, 11–17) | AN-R (94%) AN-BP (6%) |
MS, NG (NICE, 2017) | WG (>90% EBW), AWT | Non-family focused [CBT, BT, parenting elements] | 11 h/d 5 day/wks |
28.9 days (18.5, NR) | BMI: 17.2 (NR) ED symptom measure NR |
BMI: 17.9 (NR)***
ED symptom measure NR |
12 months (n = 70, 91%) BMI: 19.3 (NR)***∧ |
| UK | ||||||||||||
| Baudinet et al. (69) | 130 (95%) | Uncontrolled case series | 15.0 (1.5, 11–18) | AN-R (84%) AN-BP (5%) A-AN (5%) OSFED (6%) |
PP/SD, S, MS | AWT | Family focused [FT-AN, RO-DBT, CBT, CRT] | 6 h/d 5 days/wk |
13.4 weeks (5.9, 1–30) | %mBMI: 82.4 (8.5) EDI-3(DT): 18.3 (8.5) |
%mBMI: 89.5 (8.6)***
EDI-3(DT): 15.2 (8.9)* |
No FU |
| Pretorius et al. (70) | 24 (96%) | Uncontrolled case series | 15.6 (1.4, 12–17) | AN (71%) EDNOS (29%) |
PP/SD, S, MS | AWT | Family focused [FT-AN, DBT, CBT, CRT] | 6–8 h/d 5 days/wk |
NR | %mBMI: 78.5% (9.9) ED symptom measure NR |
%mBMI: 82.6 (9.4) | No FU |
| Simic et al. (71) | 105 (95%) | Uncontrolled case series | 15.5 (1.5, 11–18) | AN-R (91%) AN-BP (1%) ARFID (5%) OSFED (3%) |
PP/SD, S, MS | AWT | Family focused FT-AN, DBT, CBT, CRT] | 6 h/d 5 days/wk |
28.4 days (13.6, NR) | %mBMI: 79.9 (8.69) EDE-Q(G): 3.6 (1.4) |
%mBMI: 85.0 (9.10)***
EDE-Q(G): 2.6 (1.5)*** |
6 months (n = 86, 82%) %mBMI: 88 (10.6)**§ EDE-Q(G): NR |
| Germany | ||||||||||||
| Herpertz-Dahlman et al. (26) | 172 (100%) | RCT (DP [n = 87] vs. IP [n = 85] after 3 weeks of IP) | 15.2 (1.5, 11–18) | AN-R (82%) AN-BP (18%) |
S, PP, MS | AWT | Non-family focused [CBT, BT, some FT] | 8.5 h/d 5 days/wk |
Weeks: 16.5 (7.0) [DP] 14.6 (6.0) [IP] |
%EBW: 74.4 (7.0) [DP group] 75.4 (6.2) [IP group] EDI-2 (global): 248.8 (58.2) [DP group] 272.5 (59.4) [IP group] |
%EBW:***
89.0 (3.8) [DP group] 88.1 (4.7) [IP group] EDI-2 (global): NR |
12 months (post-randomization) (n = 142–161, 83–94%) %EBW:***∧ [n = 161] 89.0 (3.8) [DP group] 88.1 (4.7) [IP group] EDI-2 (global): [n = 143] 248.2 (71.1) [DP group] 256.2 (78.2) [IP group] |
| Australia | ||||||||||||
| Goldstein et al. (72) | 28 (100%) | Uncontrolled case series | 15 (12–18) | AN (79%) EDNOS (21%) |
MS, SD | Fixed length | Non-family focused [CBT, narrative therapy, distress tolerance] | 3.5 days/wk (18 h/wk) | 10 weeks fixed length | %IBW: 81.6 (7.7) EDI-3(DT): 13.8 (9.1) |
%IBW: 84.2 (10.0)**
EDI-3(DT): 10.1 (8.3)** |
6 months (n = 17–20, 61–71%) %IBW: 88.6 (12.1)**∧ [n = 20] EDI-3(DT): 5.88 (6.85)**∧ [n = 17] |
| Green et al. (73) | 42 (100%) | Uncontrolled case series | 16.7 (2.9, 12–24) | AN-R (83%) AN-BP (17%) |
MS | AWT | Non-family focused [CBT] | 5.75 h/d 5 days/wk |
22 weeks (NR, 0–52) | BMI: 17.0 (1.5) EDI-3(DT): 57.1 (28.8) |
BMI: 18.9 (1.7)**
EDI-3(DT): 31.0 (26.0)*** |
No FU |
| Israel | ||||||||||||
| Danziger et al. (74) | 32 (97%) | Uncontrolled case series | 14.5 (2.0, 10–17.5) | AN (100%) | S | WG (within 1 kg of IBW) | Family focused MDT approach | 14 h/day | NR |
38 kg (6.0) ED symptom measure NR |
47.25 kg (6.2) body image disturbance disappeared for 19/45 |
9 months (n = 32, 100%) 27/31 retained IBW |
| Danziger et al. (75) | 45 (93%) | Uncontrolled comparison (psychotherapy [n = 21] vs. not [n = 24] in first 2 months of DP) | 14.7 (2.0,10-17.5) | AN (100%) | S | AWT | Family focused MDT approach | 14 h/day | NR | 37.4 kg (6.8) [therapy group] 39.1 kg (5.3) [no therapy group] ED symptom measure NR |
42.8 kg (7.8) [therapy group] 46.4 kg (5.8) [no therapy group] (no therapy sig > therapy group**) | 13.5 months (n, % NR) +10.4 kg (4.3) [therapy group] + 11.0 kg (5.50) [no therapy group] |
*
p < 0.05;
**
p < 0.01;
***
p < 0.001.
∧
Codes for admission and discharge criteria: AWT, agreement with team; G, reaching goals; I, insurance constraints; MS, medically stable; NG, as per a national guideline; PP, poor progress; R, remission; S, severity/acuity; SD, step-down from inpatient care; W, weight cut/off; WG, weight goal.
+Significance testing for baseline to follow up difference.
§
Significance testing for discharge to follow up difference.
NR, not reported.
CT, acceptance and commitment therapy; ado., adolescent; AN, anorexia nervosa; AN-rd, anorexia nervosa and related disorders; ARFID, avoidant/restrictive food intake disorder; Ax, assessment; BED, binge eating disorder; BMI, body mass index; BN, bulimia nervosa; BN-rd, bulimia nervosa and related disorders; BT, behavior therapy; CBT, cognitive behavioral therapy; ChEAT, Children's Eating Attitudes Test; ChEAT(OC), oral control subscale of ChEAT; CRT, cognitive remediation therapy; DBT, dialectical behavior therapy; DP, day program; Dx, diagnosis; EAT-40, Eating Attitudes Test; ED, eating disorder; ED-Rs, restrictive eating disorders; EDE-Q, Eating Disorder Examination Questionnaire; EDI, Eating Disorder Inventory; EDNOS, eating disorder not otherwise specified; EDNOS-R, eating disorder not otherwise specified characterized by restriction; EOT, end of treatment; FBT, family based treatment; FOC, feat of aversive consequences; FT-AN, family therapy for anorexia nervosa; FU, follow up; IBW, ideal body weight; IOP, intensive outpatient program; IP, inpatient; LA, limited appetite or lack of interest in eating; MDT, multi-disciplinary team; MI, motivational interviewing; OSFED, other specified feeding and eating disorder; OSFED-R, other specified feeding and eating disorder characterized by restriction; PHP, partial-hospitalization program; PMM, predictors, moderators or mediators; Psychod., psychodynamic psychotherapy; RO-DBT, radically open dialectical behavior therapy; SE, selective eating due to sensory properties; UFED, unspecified feeding and eating disorder; UK, United Kingdom; YA, young adult.