Effectiveness of Family-Based Treatment for Pediatric Eating Disorders in a Tertiary Care Setting

• Published in: Clinical practice in pediatric psychology 2019-06, Vol.7 (2), p.105-115
• Main Authors: Coelho, Jennifer S., Beach, Barbara, O'Brien, Karina, Marshall, Sheila, Lam, Pei-Yoong
• Format: Article
• Language: English
• Subjects: Continuum of Care; Eating Disorders; Family Therapy; Female; Hospital Programs; Human; Inpatient; Male; Outpatient; Outpatient Treatment; Pediatrics; Treatment Outcomes; Underweight
• ISSN: 2169-4826; 2169-4834
• DOI: 10.1037/cpp0000273

Objective: A retrospective chart review was conducted to investigate outcomes in children and adolescents who entered family-based treatment (FBT) in a tertiary eating disorders treatment setting that offers treatment across the continuum of care (i.e., outpatient, day treatment, and inpatient services). Method: Chart data were extracted for children and adolescents who received FBT during the study period (2010-2016). Results: A total of 62 individuals were included in the database, 51 of whom (82.3%) were underweight (i.e., less than 95% median body mass index) at FBT start. The majority of the sample (84.3%) who were underweight at FBT admission achieved at least partial weight restoration. A portion of the sample (21%) was discharged to a more intensive treatment (i.e., day treatment or inpatient care). Weight at FBT start was examined as a potential predictor of outcomes; however, those starting FBT at a lower weight were not more likely to require intensive treatment services. Conclusions: Overall, the study supports the effectiveness of FBT in a tertiary care setting, including for those starting FBT at a very low initial body weight (that is, less than 78% median body mass index). Implications for outpatient clinical care of pediatric eating disorders will be discussed. Implications for Impact Statement Family-based treatment (FBT) for pediatric eating disorders appears to be effective in real-world settings outside of controlled research trials. Children and adolescents who start FBT at a very low initial body weight are not more likely than those who start FBT at a higher body weight to require more intensive treatment (e.g., day treatment or inpatient admission). Initial body weight at FBT start does not appear to be a pertinent criterion for determination of FBT suitability.