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Brennan, Cliona, Felemban, Lara, McAdams, Ellen, Walsh, Kevin and Baudinet, Julian (2024) An exploration of clinical characteristics and treatment outcomes associated with dietetic intervention in adolescent anorexia nervosa. Nutrients, 16(23) (4117). pp. 1-12. ISSN 2072-6643
Background:
Although dietitians possess expert knowledge on the interplay between nutrition and health, their specific role in family therapy for anorexia nervosa (FT-AN) remains a topic of debate. Some of the literature indicates insufficient evidence to affirm the impact of dietetic interventions, emphasising variability in outcomes and a need for standardised research. This study aimed to identify the clinical characteristics of adolescents requiring dietetic intervention during FT-AN and to assess differences in clinical outcomes between those receiving dietetic support and those who did not.
Methods:
A retrospective cohort study was conducted at the Maudsley Centre for Child and Adolescent Eating Disorders in London. Patients were selected from electronic records. Inclusion criteria were ICD-10 diagnosis of AN and completion of FT-AN treatment between January 2020 and December 2022. Collected data included weight (kg and %mBMI), eating disorder symptom severity, pre-assessment anxiety (patient and parent), and details of FT-AN sessions (i.e., frequency and amount). The sample was divided into two groups: those who received dietetic input and those who did not. Statistical analyses included Mann–Whitney U tests, χ2 tests, independent t-tests, and a logistic regression to examine differences at baseline, 4–6 weeks post-assessment, and discharge.
Results:
The study included 92 participants (dietetic group = 33 participants; non-dietetic group = 59 participants). Baseline characteristics were comparable between groups. The logistic regression showed no significant predictors for dietetic input. At 4–6 weeks, those requiring dietetic input exhibited lower %mBMI (83.3% vs. 87.3%, p = 0.027) and poorer weight gain (+2.3 kg vs. +3.1 kg, p = 0.04). By discharge, weight restoration was similar (92% vs. 93% mBMI, p = 0.64), although the dietetic group had more therapeutic treatment sessions (24 vs. 19, p = 0.04).
Discussion:
This study found no specific predictors for prioritising dietetic input in young people during FT-AN treatment. While those receiving dietetic support struggled with weight gain early and attended more sessions, both groups achieved similar weight outcomes by the end of treatment. Future research should focus on the timing and content of dietetic interventions, as well as perspectives from patients and caregivers, to better understand their role and impact on cognitive and emotional recovery aspects.
Available under License Creative Commons Attribution 4.0.
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