Characterizing severe and enduring anorexia nervosa: An empirical approach

About this resource

Targeted approaches for the treatment of severe and enduring anorexia nervosa (SE-AN) have been recommended, but there is no consensus definition of SE-AN to inform research and clinical practice. This study aimed to take initial steps toward developing an empirically based definition of SE-AN by characterizing associations among putative indicators of severity and chronicity in eating disorders. Patients with AN (N = 355) completed interviews and questionnaires at treatment admission and discharge; height and weight were assessed to calculate body mass index (BMI). Structural equation mixture modeling was used to test whether associations among potential indicators of SE-AN (illness duration, treatment history, BMI, binge eating, purging, quality-of-life) formed distinct subgroups, a single group with one or more dimensions, or a combination of subgroups and dimensions. A three-factor (dimensional), two-profile (categorical) mixture model provided the best fit to the data. Factor 1 included eating disorder behaviors; Factor 2 comprised quality-of-life domains; Factor 3 was characterized by illness duration, number of hospitalizations, and admission BMI. Profiles differed on eating disorder behaviors and quality-of-life, but not on indicators of chronicity or BMI. Factor scores, but not profile membership, predicted outcome at discharge from treatment. Data suggest that patients with AN can be classified on the basis of eating disorder behaviors and quality-of-life, but there was no evidence for a chronic subgroup of AN. Rather, indices of chronicity varied dimensionally within each class. Given that current definitions of SE-AN rely on illness duration, these findings have implications for research and clinical practice.

AuthorWildes, Jennifer E.; Forbush, Kelsie T.; Hagan, Kelsey E.; Marcus, Marsha D.; Attia, Evelyn; Gianini, Loren M. & Wu, Wei
JournalInternational Journal of Eating Disorders

See also

Shifting paradigms: Continuous nasogastric feeding with high caloric intakes in anorexia nervosa

Purpose The initial goal of admission for a patient with anorexia nervosa is physiologic stabilization through nutritional rehabilitation balanced against the risk of refeeding syndrome.

Read more

Confirming the Efficacy of an Adaptive Component to Family-Based Treatment for Adolescent Anorexia Nervosa: Study Protocol for a Randomized Controlled Trial.

Family-based treatment (FBT) has the largest evidence base for treating adolescents with anorexia nervosa (AN); 35-50% of cases remit at the end-of-treatment and remain remitted 3-4 years after treatment.

Read more

Autonomic Nervous System Response during Light Physical Activity in Adolescents with Anorexia Nervosa Measured by Wearable Devices.

Anorexia nervosa (AN) is associated with a wide range of disturbances of the autonomic nervous system.

Read more

Canadian practice guidelines for the treatment of children and adolescents with eating disorders.

Objectives: Eating disorders are common and serious conditions affecting up to 4% of the population.

Read more

Help us improve!

Give us feedback!

We will continue throughout 2020 to update and improve the NEDC website and welcome any feedback you may have on the site.

Provide feedback