Cited by 148Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

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The slippery slope: prediction of successful weight maintenance in anorexia nervosa

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Kaplan, A. S., Walsh, B. T., Olmsted, M., Attia, E., Carter, J. C., Devlin, M. J., Pike, K. M., Woodside, B., Rockert, W., Roberto, C. A., Parides, M.·2009·Psychological Medicine

DOI 10.1017/s003329170800442xPMC PMC4449142

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Abstract

Background: Previous research has found that many patients with anorexia nervosa (AN) are unable to maintain normal weight after weight restoration. The objective of this study was to identify variables that predicted successful weight maintenance among weight-restored AN patients. Method: Ninety-three patients with AN treated at two sites (Toronto and New York) through in-patient or partial hospitalization achieved a minimally normal weight and were then randomly assigned to receive fluoxetine or placebo along with cognitive behavioral therapy (CBT) for 1 year. Clinical, demographic and psychometric variables were assessed after weight restoration prior to randomization and putative predictors of successful weight maintenance at 6 and 12 months were examined. Results: The most powerful predictors of weight maintenance at 6 and 12 months following weight restoration were pre-randomization body mass index (BMI) and the rate of weight loss in the first 28 days following randomization. Higher BMI and lower rate of weight loss were associated with greater likelihood of maintaining a normal BMI at 6 and 12 months. An additional predictor of weight maintenance was site; patients in Toronto fared better than those in New York. Conclusions: This study found that the best predictors of weight maintenance in weight-restored AN patients over 6 and 12 months were the level of weight restoration at the conclusion of acute treatment and the avoidance of weight loss immediately following intensive treatment. These results suggest that outcome might be improved by achieving a higher BMI during structured treatment programs and on preventing weight loss immediately following discharge from such programs.

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Authors: Kaplan, A. S., Walsh, B. T., Olmsted, M., Attia, E., Carter, J. C., Devlin, M. J., Pike, K. M., Woodside, B., Rockert, W., Roberto, C. A., & Parides, M.
Affiliations: Centre for Addiction and Mental Health (CA)
New York State Psychiatric Institute (US)
University of Toronto (CA)
Corresponding author: Kaplan, A. S.
ORCID: Kaplan, A. S.
Walsh, B. T.
Olmsted, M.
Attia, E.
Devlin, M. J.
Pike, K. M.
Roberto, C. A.
Parides, M.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2008-10-10
Volume: 39
Issue: 6
Pages: 1037-1045
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s003329170800442x
PMC: PMC4449142
OpenAlex: W2057002690
Cited by: 148
References: 30
Citations by year: 2026: 1 · 2025: 4 · 2024: 10 · 2023: 6 · 2022: 10 · 2021: 12 · 2020: 11 · 2019: 12 · 2018: 8 · 2017: 10 · 2016: 13 · 2015: 12 · 2014: 12 · 2013: 6 · 2012: 7
FWCI: 5.21
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Eli Lilly and Company
Yale University
National Institutes of Health
National Institute of Mental Health (MH-060271, MH60336, R01MH060271, R01MH060336)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: anorexia nervosa, weight maintenance, weight restoration, prognostic factors, body mass index, weight loss rate, fluoxetine, cognitive behavioral therapy, inpatient care, partial hospitalization
MeSH terms: Adolescent, Adult, Anorexia Nervosa, Body Image, Body Weight, Female, Fluoxetine, Humans, Middle Aged, New York, Ontario, Placebos, Surveys and Questionnaires, Weight Gain, Weight Loss, Cognitive Behavioral Therapy, Body Mass Index, Logistic Models, Selective Serotonin Reuptake Inhibitors, Young Adult

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The slippery slope: prediction of successful weight maintenance in anorexia nervosa

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