Abstract
Objective
The study aimed to assess outcomes in patients with severe and extreme anorexia nervosa managed with enhanced cognitive behavior therapy (CBT‐E) in a real‐world outpatient setting.
Method
Thirty patients with anorexia nervosa and body mass index (BMI) <16 aged ≥17 years were recruited from consecutive referrals to an eating disorder service clinic offering outpatient CBT‐E. BMI and Eating Disorder Examination Questionnaire (EDE‐Q), Brief Symptom Inventory (BSI), and Clinical Impairment Assessment (CIA) scores were recorded at admission, end of treatment, and 20‐ and 60‐week follow‐ups for treatment completers.
Results
Twenty patients (66.7%) completed the treatment and showed both considerable weight gain (Cohen’s f = 1.43), and significantly reduced scores for clinical impairment (f = 1.26) and eating‐disorder (f = 1.03) and general psychopathology (f = 0.99). Changes remained stable at both follow‐ups. About half of the patients who completed treatment had a BMI ≥18.5 at the end of treatment and follow‐ups.
Discussion
CBT‐E seems suitable and promising for patients with severe and extreme anorexia nervosa seeking treatment in a real‐world clinical setting, provided that their medical conditions are stable, and they have no current major depressive episodes or substance abuse; it may represent a valid alternative to inpatient treatment for those who are able to sustain engagement in a full course of outpatient treatment.