BACKGROUND: Previous research has found that many patients with anorexia nervosa (AN) are unable to maintain normal weight after weight restoration. The objective of this study was to identify variables that predicted successful weight maintenance among weight-restored AN patients. METHOD:Ninety-three patients with AN treated at two sites (Toronto and New York) through in-patient or partial hospitalization achieved a minimally normal weight and were then randomly assigned to receive fluoxetine or placebo along with cognitive behavioral therapy (CBT) for 1 year. Clinical, demographic and psychometric variables were assessed after weight restoration prior to randomization and putative predictors of successful weight maintenance at 6 and 12 months were examined. RESULTS: The most powerful predictors of weight maintenance at 6 and 12 months following weight restoration were pre-randomization body mass index (BMI) and the rate of weight loss in the first 28 days following randomization. Higher BMI and lower rate of weight loss were associated with greater likelihood of maintaining a normal BMI at 6 and 12 months. An additional predictor of weight maintenance was site; patients in Toronto fared better than those in New York. CONCLUSIONS: This study found that the best predictors of weight maintenance in weight-restored AN patients over 6 and 12 months were the level of weight restoration at the conclusion of acute treatment and the avoidance of weight loss immediately following intensive treatment. These results suggest that outcome might be improved by achieving a higher BMI during structured treatment programs and on preventing weight loss immediately following discharge from such programs.
RCT Entities:
BACKGROUND: Previous research has found that many patients with anorexia nervosa (AN) are unable to maintain normal weight after weight restoration. The objective of this study was to identify variables that predicted successful weight maintenance among weight-restored AN patients. METHOD: Ninety-three patients with AN treated at two sites (Toronto and New York) through in-patient or partial hospitalization achieved a minimally normal weight and were then randomly assigned to receive fluoxetine or placebo along with cognitive behavioral therapy (CBT) for 1 year. Clinical, demographic and psychometric variables were assessed after weight restoration prior to randomization and putative predictors of successful weight maintenance at 6 and 12 months were examined. RESULTS: The most powerful predictors of weight maintenance at 6 and 12 months following weight restoration were pre-randomization body mass index (BMI) and the rate of weight loss in the first 28 days following randomization. Higher BMI and lower rate of weight loss were associated with greater likelihood of maintaining a normal BMI at 6 and 12 months. An additional predictor of weight maintenance was site; patients in Toronto fared better than those in New York. CONCLUSIONS: This study found that the best predictors of weight maintenance in weight-restored AN patients over 6 and 12 months were the level of weight restoration at the conclusion of acute treatment and the avoidance of weight loss immediately following intensive treatment. These results suggest that outcome might be improved by achieving a higher BMI during structured treatment programs and on preventing weight loss immediately following discharge from such programs.
Authors: P E Garfinkel; E Lin; P Goering; C Spegg; D Goldbloom; S Kennedy; A S Kaplan; D B Woodside Journal: Br J Psychiatry Date: 1996-04 Impact factor: 9.319
Authors: Karen K Miller; Ellen E Lee; Elizabeth A Lawson; Madhusmita Misra; Jennifer Minihan; Steven K Grinspoon; Suzanne Gleysteen; Diane Mickley; David Herzog; Anne Klibanski Journal: J Clin Endocrinol Metab Date: 2006-05-30 Impact factor: 5.958
Authors: B Timothy Walsh; Allan S Kaplan; Evelyn Attia; Marion Olmsted; Michael Parides; Jacqueline C Carter; Kathleen M Pike; Michael J Devlin; Blake Woodside; Christina A Roberto; Wendi Rockert Journal: JAMA Date: 2006-06-14 Impact factor: 56.272
Authors: Laurel E S Mayer; Janet Schebendach; Lindsay P Bodell; Rebecca M Shingleton; B Timothy Walsh Journal: Int J Eat Disord Date: 2011-04-14 Impact factor: 4.861
Authors: Manuel Föcker; Katharina Bühren; Nina Timmesfeld; Astrid Dempfle; Susanne Knoll; Reinhild Schwarte; Karin Maria Egberts; Ernst Pfeiffer; Christian Fleischhaker; Christoph Wewetzer; Johannes Hebebrand; Beate Herpertz-Dahlmann Journal: Eur Child Adolesc Psychiatry Date: 2014-08-27 Impact factor: 4.785
Authors: Joanna E Steinglass; Robyn Sysko; Laurel Mayer; Laura A Berner; Janet Schebendach; Yuanjia Wang; Huaihou Chen; Anne Marie Albano; H Blair Simpson; B Timothy Walsh Journal: Appetite Date: 2010-06-04 Impact factor: 3.868