Effectiveness of adult day treatment for eating disorders
| Published date | 03 June 2014 |
| DOI | https://doi.org/10.1108/MHRJ-01-2013-0003 |
| Pages | 131-144 |
| Date | 03 June 2014 |
| Author | Zoë Hepburn,Kim Wilson |
| Subject Matter | Health & social care,Mental health |
Effectiveness of adult day treatment for
eating disorders
Zoe
¨Hepburn and Kim Wilson
Zoe
¨Hepburn is a Clinician
and Researcher, based at
Gloucestershire Eating
Disorders Service, 2gether
NHS Foundation Trust,
Cheltenham, UK.
Kim Wilson is a Research
Assistant, based at John
Howard Centre, East London
NHS Trust, London, UK.
Abstract
Purpose – The purpose of this paper is to assess the effectiveness of day treatment programmes
for adults with eating disorders by comparing, evaluating and synthesizing published pre- and
post-treatment outcomes.
Design/methodology/approach – A systematic review was undertaken of publications containing
quantitative outcome data relating to weight restoration among underweight patients, reduction in binge
and purge/vomit symptoms, decrease in eating disorder psychopathology and improvement in
psychological functioning.
Findings – This systematic review of pre- and post- treatment outcomes from 15 studies revealed large
effect sizes relating to increase in Body Mass Index (BMI), reduction in symptoms and decrease in
depression. Medium effect sizes were observed for improvement in self-esteem and reduction in anxiety
and medium-large effect sizes were generally observed for attitude-change, although a small effect size was
identified for perfectionism.
Practical implications – This systematic review indicates that day treatment for adults is effective in
increasing BMI among underweight patients, reducing binge, purge/vomit symptoms and eating disorder
psychopathology and improving psychological functioning. Further research is required to investigate
whether gains are cost-effective and sustainable over the longer term, and how day treatment programmes
can improve outcomes for patients who are vulnerable to non-response and drop-out.
Originality/value To date, reviews of day treatment for adults with eating disorders have focused upon
comparisons of treatment approach and structure and neglected to assess outcomes. Therefore this review
fills a gap in existing literature
Keywords Outcomes, Eating disorder, Adult day treatment, Anorexia nervosa, Bulimia nervosa,
Day treatment programme
Paper type Literature review
Introduction
Background
Eating disorders are potentially fatal mental illnesses, characterized by disturbance in eating
habits, weight-control behaviour and body-image resulting in clinically significant impairment
of physical health and psychosocial functioning (Goss and Fox, 2012). Evidence supports a
multi-factorial aetiologyfor eating disorders,comprising genetic, physiological and neurochemical
factors as well as psychological and sociocultural influences (Atalayer et al., 2013). Disordered
eating usuallybegins during adolescence,and can pursue a chronic course,leading to profound
and extensive health and social consequences, including long-term disability, family dysfunction
and disruption to education and vocational functioning (Treasure et al., 2010). Furthermore, the
economic impact related to treatment, lost productivity and benefit claims is estimated at £1.26
billion per year in England alone (Henderson, 2012). Ambivalence and barriers to change can
make progresstowards recoveryfraught for sufferersand care-providersalike (Geller et al., 2012),
rendering the quest for effective treatments important.
DOI 10.1108/MHRJ-01-2013-0003 VOL. 19 NO. 2 2014, pp. 131-144, CEmerald Group Publishing Limited, ISSN 1361-9322
j
MENTAL HEALTH REVIEW JOURNAL
j
PAGE 131
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