Exploring possible mechanisms of change in family-based treatment for adolescent bulimia nervosa

Objective: Mediators of treatment for family-based treatment are explored for outcomes among adolescents with bulimia nervosa (BN). Method: Using data from a recently completed randomized clinical trial (RCT) comparing family-based treatment (FBT) to supportive psychotherapy (SPT) we examined possible mediators of treatment outcome. Results: Results suggest that FBT-BN was more effective than SPT in producing remission by virtue of achieving greater reductions in eating disorder psychopathology by mid-treatment. Specifically, reductions in cognitions related to BN as assessed by the EDE appeared to be the differentiating mechanism. Conclusion: It is reasonable to hypothesize that change in the EDE subscales mediates outcome for FBT-BN. Future studies with sufficient power to examine this possibility as an a priori hypothesis would help to better understand how FBT-BN works and may also help to guide future treatment refinement and development.