The importance of adequate treatment for eating disorders is undeniable. But what about the short-term outcomes of inpatient and outpatient treatment for Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in Germany and Switzerland? This was focus of the naturalistic study by Schopf et al. (2023) based on data assessed during a lead agency research program financed by the SNSF and DFG (lead: Simone Munsch, Switzerland). The study included 116 females diagnosed with AN or BN, who received either inpatient or outpatient treatment and were assessed at the beginning of treatment and three months later using diagnostic interviews and self-report questionnaires.
The analysis of the results revealed that full-time inpatient treatment was moderately effective in improving eating disorder pathology (d = .48), somatic (d = .77), and depressive symptoms (d = .77) in participants with AN. Particularly, the inpatient treatment group showed a significant improvement in Body Mass Index (BMI) (d = .83), whereas the outpatient treatment group demonstrated a comparatively lower improvement in BMI (d = .37). For participants with BN, inpatient treatment resulted in significant improvements in eating disorder pathology (d = .81) and somatic symptoms (d = .85), as well as moderate improvements in depressive (d = .70) and anxiety symptoms (d = .48). Outpatient treatments for BN resulted in medium improvements in eating disorder pathology (d = .43), depressive (d = .39), somatic (d = .27), and anxiety symptoms (d = .31). Overall, complete remission of symptoms was rare. Participants with AN had higher remission rates in the inpatient treatment group (full remission: 3.1%, partial remission: 18.8%) compared to the outpatient treatment group (full remission: 0%, partial remission: 14.8%). Remarkable remission rates were seen in participants with BN: Although the results were greater in inpatient treatment (full remission: 4.4%, partial remission: 30.4%), comparable results were achieved in outpatient treatment with a significantly lower number of treatment sessions (full remission: 3.1%, partial remission: 26.5%).
In summary, the findings illustrate that inpatient treatment can achieve moderate to substantial improvements in individuals with AN and BN. In terms of BMI increase, inpatient therapy was effective for AN. The outpatient therapy in individuals with BN resulted in comparable remission rates to inpatient treatment. It is worth mentioning that the study focused on short-term treatment outcomes. Therefore, it is important to investigate long-term treatment outcomes. In conclusion, these insights emphasize the ongoing need to explore effective treatment approaches to promote recovery from eating disorder.
Schopf, K., Schneider, S., Meyer, A. H., Lennertz, J., Humbel, N., Bürgy, N.-M., Wyssen, A., Biedert, E., Isenschmid, B., Milos, G., Claussen, M., Trier, S., Whinyates, K., Adolph, D., Teismann, T., Margraf, J., Assion, H.-J., Überberg, B., Juckel, G., Munsch, S. (2023). Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland. PLOS ONE, 18(6), e0280402. https://doi.org/10.1371/journal.pone.0280402
Lead agency project, funded by the Swiss National Science Foundation, SNF No.: 100014L_149416/2 (lead Simone Munsch, Switzerland) in collaboration with Silvia Schneider from Bochum, Germany, supported by the German Research Foundation, DFG: SCHN 415/41.