Eating Disorder Outcomes: Does Intensive Eating Disorder Treatment Help? 

Eating Disorder Outcomes: Does Intensive Eating Disorder Treatment Help?
 
By Laura Fewell, B.A.
 
Eating disorders (EDs) are serious illnesses that can come in lots of different forms. Restricting food, binge eating, purging, and over-exercising can lead to severe health consequences, such as imbalanced electrolytes and metabolic disturbances, slow or irregular heartbeats, and severe low or high weight. In fact, anorexia nervosa has the highest mortality rate of any mental illness. Often times, EDs are also accompanied by severe anxiety and depression. Yet many people with EDs do not understand how serious the effects of EDs are, and they are not sure where to go or what to do for help. So what are their options? Where do people go for help? And does it work?
 
Many people with eating disorders can benefit from seeing a team of outpatient specialists, such as therapists, dietitians, and psychiatrists. Yet others need more intensive treatment with structured care and medical management, such as inpatient (24 hour treatment in a hospital), residential (24 hour treatment in a home-like facility), and partial hospitalization (day treatment programs, typically 6 to 10 hours a day). But the literature shows mixed outcomes from intensive treatment centers, and much of the available research has been conducted on small samples. As the research coordinator at an eating disorder clinic, I wanted to look at the outcomes in our population and share those with others.
 
Since 2012, I have been collecting data from our patients (in either residential or partial hospitalization programming) to get a better idea of what people with EDs experience, how clients progress throughout intensive treatment, and if clients are doing better after treatment. I also wanted to investigate factors that may contribute to relapse or success after treatment, such as anxiety or how long someone has had an ED. The measures I’ve used look at ED thoughts and behaviors, social impairment, worry, depression, quality of life, and change in weight. More recently, I’ve added in measures looking at obsessive compulsive traits and compulsive exercise (stay tuned for those results!).
 
We currently have data on over 500 patients, and together with Dr. Cheri Levinson, we analyzed the data to test my two primary questions. First, do patients with eating disorders improve? And then, what thoughts and behaviors are related to improvement? We found that patients have improved ED thoughts and behaviors, social impairment, worry, depression, quality of life, and change in weight after receiving intensive ED treatment. What’s more, patients continue to have improved symptoms as long as a year following treatment discharge. This is huge! This tells us that people who have serious EDs and go through intensive treatment can not only get their health back on track, but also see improvements in their mood and quality of life. 
 
Next, we looked at what thoughts and behaviors are related to this improvement. We found that worry and depression were contributing to more eating disorder issues later on. We also found that when clients weren’t functioning at a high social level (for example, getting along with others or engaging in life activities), they were experiencing more eating disorder issues later on.  So when worry, depression, and social functioning are focused on as part of ED treatment, clients are more likely to do better after treatment. To learn more about our results, stop by the ABCT Obesity and Eating Disorders Special Interest Group Poster Session on Friday, October 27th at 6:30pm! https://www.eventscribe.com/2016/ABCT/aaSearchByDay.asp?h=Full%20Schedule&BCFO=P|MCS|WK|AM|CIT|SS|CGR|CR|IP|LA|MP|MWK|PD|SYM|INS|SIG|RPD|PA
 
While there is still much to be learned in the world of EDs, we are encouraged to find our ED treatment is effective and can lead to improved lives for those who suffer from EDs. We will continue to collect information that informs ED treatment centers practices, but in the meantime, those who struggle with EDs can be comforted to know there is help out there. 
 
If you or someone you know might struggle with an eating disorder, please reach out and talk to someone. Help can be found through the National Eating Disorders Association’s confidential hotline 1-800-931-2237. You can also reach out to Dr. Cheri Levinson at cheri.levinson@louisville.edu or to McCallum Place Eating Disorder Treatment Centers at 800-828-8158.