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A scoping review of non-specific predictors, moderators, and mediators of family-based treatment for adolescent anorexia and bulimia nervosa: a summary of the current research findings

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Abstract

Purpose

This scoping review presents an up-to-date synthesis of the current evidence base for non-specific predictors, moderators, and mediators of family-based treatment (FBT) for adolescent anorexia and bulimia nervosa.

Methods

We identify ways in which end-of-treatment outcomes have been shown to differ based upon baseline clinical features and person-specific factors and explore psychological mechanisms that may explain differences in treatment response. We draw from this evidence base to outline recommendations for clinical practice, as well as directions for future clinical eating disorder research.

Results

Noted findings from review include that early response in weight gain and parental criticism may be particularly influential in treatment for anorexia nervosa. Further, for adolescents with either anorexia or bulimia nervosa, eating-related obsessionality may be a key intervention target to improve outcomes.

Conclusion

In addition to highlighting a need for attention to specific patient- and caregiver-level factors that impact treatment response, recommendations for research and clinical practice include testing whether certain targeted treatments (e.g., exposure-based approaches) may be suitable within the context of FBT for eating disorders.

Level of evidence

Level I: Evidence obtained from: at least one properly designed randomized controlled trials; experimental studies.

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Funding

This research received no specific grant from any funding agency, commercial or not-for-profit sectors. Dr. Gorrell is supported by the National Institute of Mental Health (K23MH126201).

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA

    Sasha Gorrell & Daniel Le Grange

  2. Department of Psychology, George Mason University, Fairfax, VA, USA

    Catherine E. Byrne, Paige J. Trojanowski & Sarah Fischer

  3. Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA

    Daniel Le Grange

Authors
  1. Sasha Gorrell
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  2. Catherine E. Byrne
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  3. Paige J. Trojanowski
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  4. Sarah Fischer
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  5. Daniel Le Grange
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Contributions

The motivation for the review was inspired by CB with the guidance of DL and SF; CB and SG performed the literature search; SG and CB drafted the manuscript and all authors critically revised the work.

Corresponding author

Correspondence to Sasha Gorrell.

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Conflicts of interest

Dr. Le Grange receives royalties from Guilford Press and Routledge and is co-director of the Training Institute for Child and Adolescent Eating Disorders, LLC. All authors report no other biomedical financial interests or potential conflicts of interest.

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Communicated by Sasha.Gorrell@ucsf.edu.

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Gorrell, S., Byrne, C.E., Trojanowski, P.J. et al. A scoping review of non-specific predictors, moderators, and mediators of family-based treatment for adolescent anorexia and bulimia nervosa: a summary of the current research findings. Eat Weight Disord 27, 1971–1990 (2022). https://doi.org/10.1007/s40519-022-01367-w

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