How important are motivation and initial Body Mass Index for outcome in day therapy services for eating disorders?

Abstract

This study was designed to investigate the impact of initial Body Mass Index (BMI) and motivation for recovery on a 12-week day therapy programme for Eating Disorders. Outcome was assessed by changes in eating disorder symptomology, mood and self-esteem. A battery of assessment questionnaires was given to 34 eating disorder clients on admission to and completion of the programme. This study found that BMI at admission did not affect treatment outcome directly. Only patient self-rated motivation directly affected treatment outcome with more highly motivated clients making more significant changes to their eating disorder symptomology across the programme. However, motivation, BMI and duration of illness influenced how likely a patient was to complete the 12 weeks and completion of the programme had a direct effect on eating disorder symptomology, mood and self-esteem. BMI and motivation can therefore be seen to indirectly effect the outcome of treatment via the ability to complete the programme.

The relation of weight suppression and BMI to bulimic symptoms

“…Past research has found that a low BMI predicts greater bulimic pathology in patients with anorexia nervosa (AN) at the end of treatment (9) and greater drop out from treatment amongst a sample with either AN or BN (10). The combination of past and current findings on low BMI and on weight suppression suggests that both influences could exacerbate symptoms and undermine treatment.…”

“…To date, highest weight has not been predictive of BN symptoms or treatment outcome (2, 8). However, current weight is independently predictive of BN symptoms and outcome, with those who have lower weights demonstrating higher rates of BN pathology (9) and higher risk of treatment dropout (10). …”

An evaluation of the effectiveness and short‐term stability of an innovative Australian day patient programme for eating disorders

“…Hence, although in the current study eating psychopathology was high, participant's 'preparation stage' readiness to change at admission to treatment may have played a role in precipitating improvement in eating disorder symptomatology. Jones, Bamford, Ford, and Schreiber-Kounine (2007) noted that admission motivation indirectly effected DP treatment outcome via influencing how likely a patient was to complete treatment.…”

Motivation to change among residential treatment patients with an eating disorder: Assessment of the multidimensionality of motivation and its relation to treatment outcome

“…12,13 In contrast, a key advantage of the decision making model of change is its conceptualization of motivation as multidimensional instead. This multidimensional model is well-suited to assessment of the ambivalence (i.e., simultaneous internalization of both pros and cons of illness) that is common among patients with eating disorders.…”