Predictors of psychological outcome in patients with eating disorders: A routine outcome monitoring study.

BACKGROUND: Identifying predictors of psychological outcome for patients with eating disorders may improve the effectiveness of treatment. Patients with different pre-treatment characteristics and symptoms may benefit from different therapies. This study aimed to identify potential predictors of treatment outcome in a large naturalistic cohort of patients with an eating disorder. METHOD: The study sample included patients (N = 1153) with all types of eating disorders who were receiving residential, day, or outpatient treatment. Remission was defined by means of four different indicators based on the Eating Disorder Examination-Questionnaire global score: 1. achieving reliable change; 2. showing a 50% reduction in baseline symptom severity; 3. reaching the clinical significance cut-off point; and 4. a combination of indicators 2 and 3. Potential predictor variables were investigated in univariate and multivariate Cox regression models. RESULTS: Different predictors were found for the four outcome criteria. Patients with high levels of interpersonal distrust at baseline were less likely to have achieved reliable change in eating disorder psychopathology. Higher self-esteem and less body dissatisfaction at baseline was independently associated with a symptom reduction of more than 50% and/or reaching the clinical significance cut-off point. Contrary to our expectations, no differences in outcome were found between the eating disorder subtypes. DISCUSSION: Clinically, it is important to reduce the risk of poor outcome and to achieve a rapid response in treatment using an intervention designed for this purpose, such as shared decision making or an intervention directed at self-esteem or body image, which may act as a catalyst for change. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:863-873).

Novel methods to help develop healthier eating habits for eating and weight disorders: A systematic review and meta-analysis.

This paper systematically reviews novel interventions developed and tested in healthy controls that may be able to change the over or under controlled eating behaviours in eating and weight disorders. Electronic databases were searched for interventions targeting habits related to eating behaviours (implementation intentions; food-specific inhibition training and attention bias modification). These were assessed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. In healthy controls the implementation intention approach produces a small increase in healthy food intake and reduction in unhealthy food intake post-intervention. The size of these effects decreases over time and no change in weight was found. Unhealthy food intake was moderately reduced by food-specific inhibition training and attention bias modification post-intervention. This work may have important implications for the treatment of populations with eating and weight disorders. However, these findings are preliminary as there is a moderate to high level of heterogeneity in implementation intention studies and to date there are few food-specific inhibition training and attention bias modification studies.