Implementation of an adapted family-based eating disorder protocol enhanced with dietician support in a community private practice: evidence of full remission.

Abstract

Treatment of adolescent eating disorders (EDs) has been hampered by the challenge of transporting Family-Based Treatment (FBT) to community clinicians. This case series study examined the effectiveness of an enhanced FBT protocol implemented by a private practitioner. Twenty-five patients with a DSM-5 ED diagnosis received a week of intensive, FBT-derived treatment followed by an outpatient protocol that enhanced traditional FBT by including consultation with a dietician and planned feared food exposures (M = 19.70 sessions). Percent expected body weight (%EBW), depression, and ED questionnaires (e.g. EDI-3) were obtained at the beginning of treatment and at 6 months. All 20 treatment completers achieved weight restoration. Substantial improvements (ES 0.96-2.11) were seen in %EBW, ED scores, and depression. Seventy-nine percent attained physical and psychological remission, 10% were "partially recovered," and 10% continued clinically elevated ED symptoms. An empirically informed, enhanced FBT protocol implemented by a private clinician produced weight restoration and ED symptom improvement within 6 months.