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Cited by 48Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa

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Redgrave, Graham W., Schreyer, Colleen C., Coughlin, Janelle W., Fischer, Laura K., Pletch, Allisyn, Guarda, Angela S.·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.641861PMC PMC7946839
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Abstract

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women ( N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill <7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (>75% reached BMI ≥ 19 kg/m 2 in both groups). At 6-month follow-up ( n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m 2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m 2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m 2 . Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m 2 .

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  1. [26]American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Press (1994).

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Authors
Redgrave, G. W., Schreyer, C. C., Coughlin, J. W., Fischer, L. K., Pletch, A., & Guarda, A. S.
Affiliations
  • Johns Hopkins University (US)
  • Children's National (US)
Corresponding author
Redgrave, Graham W.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-02-25
Volume
12
Pages
641861-641861
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.641861
PMC
PMC7946839
OpenAlex
W3135269845
Cited by
48
References
45
Citations by year
2026: 3 · 2025: 11 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 6
FWCI
5.80
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, severe and enduring anorexia nervosa, weight restoration, body mass index, disease duration, illness chronicity, depression, drive for thinness, body dissatisfaction, bulimia nervosa

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