OBJECTIVE: To ascertain the role of baseline measures of body-image concern (BIC) in changes in body mass index (BMI) centile and psychopathological outcomes associated with intensive enhanced cognitive behavioral therapy (CBT-E) in adolescents with anorexia nervosa (AN). METHOD: The BMI centile of 62 adolescent patients with AN was recorded at four time-points over 12 months, and Eating Disorder Examination interview (EDE) and Brief Symptom Inventory (BSI) scores, were recorded at admission and discharge from CBT-E. Changes in three BIC components, namely "Preoccupation with shape/weight", "Fear of weight gain" and "Feeling fat", were assessed at admission and discharge. RESULTS: CBT-E was associated with a significant improvement in outcome variables and BIC components. Among completers, 96.4% reached an end-of treatment BMI centile corresponding to a BMI ≥ 18.5 at 18 years, which fell slightly to 78.7% and 80.4% at 6- and 12-month follow-ups, respectively. Baseline "Preoccupation with shape/weight" and "Feeling fat" predicted improvement in BMI centile over time, and all three baseline BIC components independently predicted end-of-treatment EDE Eating Concern subscale score. Baseline "Feeling fat" also predicted end-of-treatment EDE Dietary Restraint subscale and BSI scores. DISCUSSION: These findings highlight the importance of assessing and addressing body image when managing adolescent patients with AN.
OBJECTIVE: To ascertain the role of baseline measures of body-image concern (BIC) in changes in body mass index (BMI) centile and psychopathological outcomes associated with intensive enhanced cognitive behavioral therapy (CBT-E) in adolescents with anorexia nervosa (AN). METHOD: The BMI centile of 62 adolescent patients with AN was recorded at four time-points over 12 months, and Eating Disorder Examination interview (EDE) and Brief Symptom Inventory (BSI) scores, were recorded at admission and discharge from CBT-E. Changes in three BIC components, namely "Preoccupation with shape/weight", "Fear of weight gain" and "Feeling fat", were assessed at admission and discharge. RESULTS: CBT-E was associated with a significant improvement in outcome variables and BIC components. Among completers, 96.4% reached an end-of treatment BMI centile corresponding to a BMI ≥ 18.5 at 18 years, which fell slightly to 78.7% and 80.4% at 6- and 12-month follow-ups, respectively. Baseline "Preoccupation with shape/weight" and "Feeling fat" predicted improvement in BMI centile over time, and all three baseline BIC components independently predicted end-of-treatment EDE Eating Concern subscale score. Baseline "Feeling fat" also predicted end-of-treatment EDE Dietary Restraint subscale and BSI scores. DISCUSSION: These findings highlight the importance of assessing and addressing body image when managing adolescent patients with AN.
Keywords:
adolescent; body image; cognitive behavioral therapy; eating disorder psychopathology; fear of weight gain; feeling fat; inpatient treatment; preoccupation with shape or weight
Authors: Jojanneke M Bijsterbosch; Anouk Keizer; Paul A Boelen; Femke van den Brink; Unna N Danner; Lot C Sternheim Journal: J Eat Disord Date: 2021-12-20