Predictors and moderators of outcome in family-based treatment for adolescent bulimia nervosa.

OBJECTIVE: To explore the predictors and moderators of treatment outcome for adolescents with bulimia nervosa (BN) who participated in family-based treatment or individual supportive psychotherapy.

METHOD: Data derived from a randomized controlled trial (n = 80) of family-based treatment of BN and supportive psychotherapy were used to explore possible predictors and moderators of treatment outcome.

RESULTS: Participants with less severe Eating Disorder Examination eating concerns at baseline were more likely to have remitted (abstained from binge eating and purging) after treatment (odds ratio [OR] 0.47; p <.01) and follow-up (OR 0.53; p <.01), regardless of the treatment that they received. Participants with lower baseline depression scores were more likely to have partial remission (no longer meeting study entry criteria) after treatment (OR 0.93; p <.01), whereas those with fewer binge-eating/purging episodes at baseline were more likely to have partial remission at follow-up (OR 0.98; p <.05). In terms of moderators, participants with less severe eating disorder psychopathology (Eating Disorder Examination global score), receiving FBT-BN, were more likely to meet criteria for partial remission at follow-up (OR 0.44; p <.05).

CONCLUSIONS: Lower eating concerns are the best predictor of remission for adolescents with BN, and family-based treatment of BN may be most effective in those cases with low levels of eating disorder psychopathology.