Mandating weekly weight gain in a day treatment program for eating disorders

Abstract

Objective: We examined differences in treatment outcome associated with a "self-directed"- versus "external-incentive"-based day treatment protocol for individuals with eating disorders (EDs) with below normal body mass index. The self-directed protocol recommended a weekly 500 g weight gain, but allowed participants freedom to gain weight at their own rate; the "external-incentive" protocol required a minimum weight gain of 500 g/week as a requirement for staying in the program.

Method: Weight outcome was available for 49 individuals who were treated with the recommended weight gain protocol, and 40 individuals who were treated with the required weight gain protocol.

Results: Post-treatment weight was significantly higher in patients treated in the required weight gain protocol compared to those treated in the recommended weight gain protocol. All patients, regardless of which program they completed, showed improvements in the measures of eating-disorder and comorbid-psychiatric symptoms.

Discussion: This study demonstrated the benefits of an alteration in protocol that required no additional financial or human resources. Further studies are needed to validate the effectiveness of various day treatment protocol parameters.

Keywords: day treatment; eating disorders; weight gain.