Predictors of Treatment Outcome in an Early Intervention Eating Disorder Sample

To examine baseline predictors of treatment completion and clinical outcomes in 16 to 25-year-olds referred for early intervention for a recent-onset eating disorder (ED).

Participants (n = 228; 93% female, 63% White British) were drawn from the FREED-Up study, which evaluated First episode Rapid Early intervention for EDs (FREED) in England across 2017-2018. Measures were completed at baseline and 3-, 6- and 12-months. Generalized estimating equations were used to identify baseline predictors of treatment completion and symptom remission by 12-months. Linear mixed models were used to identify baseline predictors of change in global eating disorder examination-questionnaire (EDE-Q) scores, binge eating, purging and BMI (anorexia nervosa [AN] only) over 12-months. Possible predictors included baseline ED symptoms, depression, anxiety, stress, psychosocial impairment, expressed emotion from close others, functioning against personalized goals, age, ethnicity, duration of illness, waiting times and BMI.

There were no significant predictors of treatment completion. Lower stress at baseline predicted increased likelihood of symptom remission by 12 months. Lower purging and psychosocial impairment at baseline predicted lower Global EDE-Q scores over the following 12 months; lower purging predicted lower rates of binge eating; and lower Global EDE-Q scores, binge eating and assessment waiting times predicted lower rates of purging. Higher purging at baseline was associated with higher BMI in AN.

This study provides new data on predictors of treatment outcomes in an early intervention ED sample. In addition to ED symptoms and waiting times, psychosocial impairment and stress warrant consideration as factors that may influence treatment outcomes.