Detemining factors for target weights in an anorexia nervosa inpatient program for adolescents and young adults: study on the links between theory-based hypotheses and the realities of clinical practice

Abstract

Background: The aim is to study if the determination of target weights in a clinical therapeutic contract which guides weight gain for adolescent inpatients with anorexia nervosa (AN) is based on clearly pre-defined, objective clinical elements.

Method: Treating psychiatrists completed patient information questionnaires for 139 anorexic adolescent inpatients. These questionnaires included information related to factors that the clinical team had hypothesized to be decisive in weight contract determination. Comparative statistical procedures evaluated whether these factors were in fact decisive in clinical practice.

Results: The two weight objectives comprising our therapeutic contract (separation end weight and final discharge weight) were significantly related to the clinical variables tested: separation end weight was explained by the theoretical separation end weight, the range of contract, and the desires of the patient and her parents; final discharge weight was explained by patient body mass index before AN and by the desires of the patient and her parents.

Conclusion: The therapeutic contract is based on objective criteria and implemented by our team in accordance with its theoretical design. It is therefore possible to establish goal weights in a defined and reliable manner.