Description of the Sample
This analysis includes all patients with a primary diagnosis of Anorexia Nervosa (AN) who participated in an evaluation followed by a minimum of one therapy session with me between the start of my practice in 2009 and spring 2017. Given that this is an analysis of end of treatment outcomes, patients who are currently in treatment with me were not included in this sample. Patients and families whom I saw only for evaluations or consultations rather than treatment were not included in this sample.
The sample includes 60 individuals (93% female) who ranged in age from 10 – 37 years old, with a median age of 16 and a modal age of 13. The majority of patients identified as Caucasian (69%) or Hispanic (29%), with less than 3% identifying with other racial/ethnic groups.
Twenty percent of patients in this sample met criteria for the Binge-Purge Subtype of AN, while the remaining 80% had Restricting Subtype.
Half of patients in this sample had a comorbid diagnosis. The two most common comorbid diagnosis were ADHD and Major Depressive Disorder, with 13% of patients meeting criteria for each of these disorders.
Duration of illness before beginning treatment with me ranged from 2 months to 21 years, with older patients, on average, having been sick for a longer duration of time. The mean duration of illness before entering treatment with me was just under 3 years.
Most patients had a history of unsuccessful outpatient treatment with other providers prior to beginning treatment with me. In addition, 28% percent of patients had a history of hospitalization for AN prior to beginning treatment with me and 15% had a history of residential treatment.
Ten percent of the sample paid a reduced rate for services due to financial need.
What follows is a summary of treatment outcomes. For a more detailed description of treatment outcomes for patients with AN, click here.
Description of Treatment Received
- 95% of child and adolescent patients received Family-Based Treatment (FBT). The remaining 5% received individual therapy.
- 40% of patients over age 18 received FBT, either alone or in conjunction with individual therapy. The remaining 60% received individual therapy.
- Some adolescent FBT patients received individual therapy for a co-morbid condition after their course of FBT was complete.
- All patients received medical monitoring by their physician during treatment with me.
- 58% of patients took psychotropic medication at some point during their treatment with me.
- Average number of sessions attended was 23.
- Average duration of treatment was 13 months.
Reasons for Treatment Ending
- 50% of patients completed a full course of treatment with me
- 26% dropped out of treatment prematurely
- 22% were referred to other providers
- 3% moved to other geographic locations during treatment
- 97% of patients who completed treatment achieved full recovery. The remaining 3% achieved physical remission.
- The majority of patients who completed treatment did so in a time frame of somewhere between 7 months and 2 years.
- A full course of treatment required, on average, 27 sessions over the course of 17 months.
- Patients with co-morbid conditions required more sessions, on average, than those without co-morbid conditions.
- All patients who completed treatment achieved 100% full weight restoration, as indicated by a return to their pre-AN percentile patterns of growth for height and weight.
- Average time to achieve weight restoration was 3.6 months.
- Patients who recovered with individual therapy took longer, on average, to achieve weight restoration than those who recovered through FBT.
- 26% of patients dropped out of treatment prematurely.
- Patients receiving individual therapy were almost twice as likely as those receiving FBT to drop out of treatment prematurely.
- For treatment drop-outs, there was a significant correlation between length of time spent in treatment and progress made.
- All treatment dropouts who were in treatment with me for at least 2 months had made significant progress at the time of drop-out.
- Patients who dropped out of treatment after one month or less had not made any progress at the time of drop-out.
Status at End of Treatment with Me
Recovery status was assessed for each patient as of his/her final session with me, regardless of the reason for treatment ending. The statistics listed below are for the entire sample of patients, including those who completed a full course of treatment, those who dropped out prematurely, and those who were referred to other providers due to a geographic move or a need for a different level of care or type of care.
- 48% had achieved full recovery
- 2% achieved physical remission
- 22% made significant progress
- 5% made some progress
- 18% made no progress
- 3% regressed
Predictors of Positive Treatment Outcome
- Completion of a full course of treatment: 97% of those who completed treatment achieved full remission.
- Younger age (Children under 13 had the highest rates of full recovery, followed by adolescents ages 13-17).
- Patients receiving FBT were almost twice as likely as those receiving individual therapy to achieve full recovery.
- Males were more likely to achieve full recovery than females.
- Patients with Restricting Anorexia Nervosa were more than twice as likely as those with Binge-Purge Anorexia Nervosa to achieve full recovery.
- Patients taking psychotropic medication during treatment were somewhat more likely to achieve full recovery than those who did not take psychotropic medication.
- Patients who paid full rate for treatment were somewhat more likely to achieve full recovery than those who paid a reduced rate due to financial need.
- Caucasian (non-Hispanic) patients were somewhat more likely than Hispanic patients to achieve full recovery.