Predictors of outcome at 1 year in adolescents with DSM-5 restrictive eating disorders: report of the national eating disorders quality improvement collaborative

J Adolesc Health. 2014 Dec;55(6):750-6. doi: 10.1016/j.jadohealth.2014.06.014. Epub 2014 Sep 4.

Abstract

Purpose: The National Eating Disorders Quality Improvement Collaborative evaluated data of patients with restrictive eating disorders to analyze demographics of diagnostic categories and predictors of weight restoration at 1 year.

Methods: Fourteen Adolescent Medicine eating disorder programs participated in a retrospective review of 700 adolescents aged 9-21 years with three visits, with DSM-5 categories of restrictive eating disorders including anorexia nervosa (AN), atypical AN, and avoidant/restrictive food intake disorder (ARFID). Data including demographics, weight and height at intake and follow-up, treatment before intake, and treatment during the year of follow-up were analyzed.

Results: At intake, 53.6% met criteria for AN, 33.9% for atypical AN, and 12.4% for ARFID. Adolescents with ARFID were more likely to be male, younger, and had a longer duration of illness before presentation. All sites had a positive change in mean percentage median body mass index (%MBMI) for their population at 1-year follow-up. Controlling for age, gender, duration of illness, diagnosis, and prior higher level of care, only %MBMI at intake was a significant predictor of weight recovery. In the model, there was a 12.7% change in %MBMI (interquartile range, 6.5-19.3). Type of treatment was not predictive, and there were no significant differences between programs in terms of weight restoration.

Conclusions: The National Eating Disorders Quality Improvement Collaborative provides a description of the patient population presenting to a national cross-section of 14 Adolescent Medicine eating disorder programs and categorized by DSM-5. Treatment modalities need to be further evaluated to assess for more global aspects of recovery.

Keywords: ARFID; Adolescents; Anorexia nervosa; Atypical anorexia nervosa; DSM-5; Quality improvement; Restrictive eating disorder; Weight recuperation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Medicine / methods*
  • Adult
  • Age Factors
  • Body Mass Index
  • Body Weight
  • Child
  • Cooperative Behavior
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feeding and Eating Disorders / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Program Evaluation / methods*
  • Program Evaluation / statistics & numerical data
  • Quality Improvement
  • Retrospective Studies
  • Sex Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult