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.