Early weight gain in family-based treatment predicts greater weight gain and remission at the end of treatment and remission at 12-month follow-up in adolescent anorexia nervosa

Objective To Identify whether early weight gain in family-based treatment (FBT) predicted greater weight and remission at end of FBT and 12-month follow-up. Method Eighty-two adolescents, with anorexia nervosa, participated in a randomized control trial comparing brief hospitalization for medical stabilization and hospitalization for weight restoration to 90% expected body weight (EBW) (1:1), followed by 20 sessions of FBT. Sixty-nine completed trial protocol. Receiver operating characteristic analyses were conducted investigating whether early weight-gain in FBT predicted outcomes at end of FBT and 12-month follow-up. Participants were analyzed according to their original randomization and as a combined set. Binary logistic regression was used to control for randomization arm effect in combined set analysis. Results Weight gain greater than 1.8 kg at FBT Session 4 predicted greater %EBW (99.18 SD-=-6.93 vs. 92.79 SD-=-7.74, p-<-.05) and remission at end of FBT (46% vs. 11%, p-<-.05) and at 12-month follow-up (64% vs. 36%, p-=-.05). Binary logistic regression confirmed weight gain greater than 1.8 kg predicted remission (p-<-.05) while treatment arm randomization did not add significantly to the model. Discussion Early weight gain has potential to distinguish likely responders in FBT from those who may need more intensive intervention to achieve remission offering the potential to improve outcomes.