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Objective Early response, as indicated by early weight gain, in family‐based treatment (FBT) for adolescent anorexia nervosa (AN) predicts remission at end of treatment. However, little is known about what factors contribute to early response. Further, no previous studies have examined early response to separated forms of FBT. Method Data from a randomised clinical trial of conjoint FBT and separated FBT (parent‐focused treatment, PFT) were analysed to examine the timing and amount of early weight gain that predicted remission and identify factors associated with early response. Results Weight gain of at least 2.80 kg in FBT (N = 55) and 2.28 kg in PFT (N = 51), by Session 5, were the best predictors of remission at end of treatment. Early response in FBT was predicted by greater paternal therapeutic alliance and lower paternal criticism. Early response in PFT was predicted by less severe eating‐disorder symptoms and negative affect at baseline, lower maternal criticism, and greater adolescent therapeutic alliance. Conclusions The results confirm that early weight gain is an important prognostic indicator in both conjoint FBT and PFT and suggest that addressing negative emotion, parental criticism, and therapeutic alliance early in treatment could improve remission rates.

Purpose Many women with eating disorders (EDs) have comorbid posttraumatic stress disorder (PTSD). However, there have been few studies on how comorbid PTSD may impact ED treatment outcomes. Method Participants were 2,809 patients from residential ED treatment facilities who were treated using the Unified Treatment Model (UTM). We investigated whether PTSD diagnosis at admission was associated with changes in Eating Disorder Examination‐Questionnaire (EDE‐Q) scores, binge eating, self‐induced vomiting, and restriction, across three time points, as well as clinically significant improvement and treatment drop‐out. Results Using latent growth models, with time modeled as a second‐order polynomial, we found that EDE‐Q scores and behavioral symptoms decreased from admission to discharge, but increased from discharge to 6‐month follow‐up. PTSD diagnosis was associated with higher baseline EDE‐Q scores and restriction, and lower binge‐eating frequency. PTSD diagnosis was not associated with symptom change over time, treatment dropout, or clinically significant change. Discussion Although PTSD diagnoses were associated with higher ED symptom levels at admission, PTSD was not associated with worse treatment outcomes, suggesting the UTM is a promising treatment for patients with and without PTSD. Future studies should investigate the impact of ED treatment on PTSD symptoms in order to determine the need for integrated treatments for these comorbid conditions.

Objective: Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression (DWS) here). Method: We compared the relationships between traditional weight suppression (TWS) and DWS and a wide variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub-clinical bulimia nervosa. Results: TWS and DWS were correlated (r = .40). TWS was significantly related to only one of 23 outcome variables whereas DWS showed significant or near-significant relationships to 14 outcomes. DWS showed consistent positive relations with behavioral outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns). Conclusions: Findings indicated a much more consistent relationship between the novel DWS measure and bulimic characteristics than with the traditional weight suppression measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.

Background: The Renfrew Unified Treatment for Eating Disorders and Comorbidity (UT) is a transdiagnostic, emotion-focused treatment adapted for use in residential group treatment. This study examined the effect of UT implementation across five years of treatment delivery.Methods: Data were collected by questionnaire at admission, discharge (DC), and 6-month follow-up (6MFU). Patient outcomes were measured by the Eating Disorder Examination-Questionnaire, Center for Epidemiologic Studies-Depression Scale, Brief Experiential Avoidance Questionnaire (BEAQ), Anxiety Sensitivity Index, and Southampton Mindfulness Scale. Data were analyzed for N = 345 patients treated with treatment-as-usual (TAU), and N = 2,763 treated with the UT in subsequent years.Results: Results from multilevel models demonstrated a significant interaction between implementation status (TAU vs. UT) and time, both linear and quadratic, for the depression, experiential avoidance, anxiety sensitivity, and mindfulness variables. Patients treated with the UT showed more improvement in these variables on average, as well as more rebound between DC and 6MFU. Results from multilevel models examining eating disorder outcome showed no significant difference between the TAU and UT for the full sample, but a significant three-way interaction indicated that the UT produced more improvement in the EDE-Q relative to the TAU particularly for patients who entered treatment with high levels of experiential avoidance (BEAQ score).Conclusion: This long-term study of a transdiagnostic, evidence-based treatment in residential care for eating disorders and comorbidity suggests implementation was associated with beneficial effects on depression and emotion function outcomes, as well as eating disorder severity for patients with high levels of baseline emotion regulation problems. These effects did not appear to diminish in the 5 years following initial implementation.

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Objective The oscillations between binge eating, purging, and dieting in bulimia nervosa (BN) may produce substantial within‐subject weight variability. Although weight variability has been predictive of eating‐ and weight‐related variables in community samples, it has not been empirically examined in eating disorders. The current study examined cross‐sectional and prospective associations between weight variability and BN pathology. Method Four weights were collected over an average of 42.02 days, and weight variability was calculated as the root mean square error around each individual's weight trajectory regression line. Linear regressions were performed to examine the association between weight variability and eating disorder psychopathology, cross‐sectionally at baseline and prospectively at 6‐month follow‐up, adjusting for baseline BMI. Results Weight variability was cross‐sectionally associated with eating pathology, but these relationships became non‐significant after adjusting for BMI. However, at 6‐month follow‐up, greater baseline weight variability predicted increases in body dissatisfaction, shape and weight concerns, and global eating pathology, even after adjusting for baseline BMI. Discussion These findings demonstrate, for the first time, that within‐subject weight variability predicts greater eating disorder pathology over time in BN. The results add to evidence that weight history variables contribute to BN psychopathology above and beyond well‐documented psychological dysfunction in BN.