Family-based treatment for adolescent anorexia nervosa: A meta-analysis

Abstract

Anorexia nervosa (AN) is a complex illness that typically onsets during adolescence and has severe consequences. Family-based treatment (FBT) is currently regarded as the leading treatment option for adolescents with AN; however, there is confusion within the literature as to what exactly constitutes FBT. This meta-analysis aimed to examine the specific efficacy of FBT in increasing weight gain and reducing eating disorder (ED) symptomology for adolescents with AN. Inclusion criteria required that studies followed the manualised FBT model, be restricted to adolescents, and have patients with diagnosed AN. Several databases were searched: MEDLINE, PsycINFO, Google Scholar, ProQuest Dissertations & Theses, and SCOPUS, and retrieval was limited to between 1984 and November 2023. Once identified, studies were screened and coded by two researchers who met to resolve any disagreements. Thirteen studies met the eligibility criteria. The impact of FBT on treatment outcomes revealed a large effect size for continuous (d = 0.955, 95% CI [0.386–1.523], p < 0.001) and remission (d = 2.32, 95% CI [1.827, 2.807], p < 0.001) outcomes. However, outcome measures varied across studies. These findings corroborate previous literature finding that FBT is an effective treatment for adolescents with AN. They also demonstrate the applicability and utility of this treatment across different cultures. FBT is a promising treatment modality to alleviate adolescents' physical and psychological suffering while also enhancing family relationships. Additionally, as an outpatient and low-resource-intensive treatment, it helps to reduce the healthcare burden.