Are we overdosing treatment? Secondary findings from a study following women with bulimia nervosa after inpatient treatment.

About this resource

OBJECTIVE: Provision of eating disorder (ED) treatment in practice is often guided by national health service structures rather than evidence-based treatment recommendations. Especially for more severely or chronically ill patients, clinicians seem to advocate a "the more the better" strategy of treatment provision. Exploring the dose-response relationship in ED treatment may shed light on both beneficial and detrimental effects of prolonged treatment provision. METHOD: We utilized data from 64 women from the treatment-as-usual (TAU) group of a randomized controlled trial on Internet-based aftercare for women with bulimia nervosa who had received inpatient treatment. We examined the relationship between treatment duration and dose and (1) baseline patient characteristics and (2) treatment outcomes (abstinence from binge eating and compensatory behaviors, frequency of binge eating and vomiting, thin ideal internalization, and general psychopathology) at 18-month follow up. RESULTS: On average, the women in our study were hospitalized for 9 weeks and most received high doses of subsequent outpatient psychotherapy (median: 45 sessions). The severity of symptoms that a patient experienced at hospital admission or discharge was largely unrelated to the amount of outpatient treatment she subsequently received. Longer inpatient treatments or higher doses of subsequent outpatient treatment did not result in more favorable outcomes. DISCUSSION: Our findings suggest that, instead of providing costly long treatment without evidenced benefit to patients, there is a need for further exploration of and discussion about the risks and benefits of providing high doses of treatment for both individuals and the health care system.

AuthorBeintner, Ina; Jacobi, Corinna
JournalThe International journal of eating disorders

See also

Night eating syndrome in patients with eating disorders: Is night eating syndrome distinct from bulimia nervosa?

BACKGROUND/PURPOSE: Night eating syndrome (NES) is a diagnosis newly introduced in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders.

Read more

Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment

The affect regulation model of binge eating, which posits that patients binge eat to reduce negative affect (NA), has received support from cross-sectional and laboratory-based studies.

Read more

Evaluating the quality of websites relating to diet and eating disorders

OBJECTIVE: To verify whether the Credibility Indicator is able to evaluate the quality of websites.

Read more

Psychological treatments for bulimia nervosa and binging (Review)

BACKGROUND A specific manual-based form of cognitive behavioural therapy (CBT) has been developed for the treatment of bulimia nervosa (CBT-BN) and other common related syndromes such as binge eating disorder.

Read more

Help us improve!

Give us feedback!

We will continue throughout 2019 to update and improve the NEDC website and welcome any feedback you may have on the site.

Provide feedback