An Archival Evaluation of the Effect of Eating and Body Image on Distress and Outcomes at a University Counseling Center

ABSTRACT The objective of this study was to evaluate the initial general distress levels and unique recovery trajectories of clients who report eating and body image concerns. Data from 3,129 participants were evaluated using one-way analysis of covariance to evaluate differences in initial distress as measured by the Outcome Questionnaire–45, and hierarchical linear modeling to explore recovery trajectories. Clients with eating and body image concerns reported higher general distress at intake (Cohen’s d between 0.48 and 0.95) and were found to recover less quickly. They were also significantly less likely to reach clinically significant criteria for recovery (odds ratio [OR] = 0.69), less likely to achieve reliable positive change (OR = 0.77), and more likely to experience no change or deterioration (OR = 1.33 and OR = 1.29). A thorough initial eating disorder assessment is recommended to aid with treatment planning and addressing eating-disorder-specific symptoms directly and early.