Does 24/7 care result in better outcomes for adults with eating disorders? A comparison of inpatient/residential care to partial hospitalization/intensive outpatient care for patients at low BMIs.

Background: Higher level of care (HLOC) treatment for eating disorders (EDs) is sometimes necessary, but research is lacking on whether HLOCs are actually more effective than less structured, lower levels of care. The purpose of the current study was to compare outcomes for patients with EDs at low weights who entered 24/7 care (inpatient and residential) to those entering non-24/7 care (partial hospitalization programming and intensive outpatient programming).

Methods: Participants were 1104 adults with body mass indices (BMI) between 14 and 17 receiving treatment for an ED at a large multisite treatment facility offering HLOCs between August 2019 and February 2024.

Demographic, Social, Behavioral, and Clinical Characteristics Associated with Long-Term Opioid Therapy and Any Opioid Prescription in High-Risk VA Patients.

Background: Social risks (individual social and economic conditions) have been implicated as playing a major role in the opioid epidemic and may be more prevalent in the most medically vulnerable patients. However, the extent to which specific social risks and other patient factors are associated with opioid use among high-risk patients has not been comprehensively assessed.

Objective: To identify patient-reported and electronic health record (EHR)-derived demographic, social, behavioral/psychological, and clinical characteristics associated with opioid use in Veterans Affairs (VA) patients at high risk for hospitalization or death.

Predictors of treatment outcome in higher levels of care among a large sample of adolescents with heterogeneous eating disorders.

Background: Despite widespread use of higher levels of care in treating eating disorders in adolescents, research supporting the use of these treatments remains limited by small sample sizes and a predominant focus on anorexia nervosa. Further, existing data regarding predictors of outcome have yielded mixed findings. In the current study, we evaluated treatment outcomes and predictors of outcome among a large sample of adolescents with eating disorders presenting to inpatient, residential, partial hospitalization programs, and intensive outpatient programs across the United States.

Weight gain in anorexia nervosa across age groups in higher levels of care.

Eating disorders (EDs) have historically been thought of as afflictions of younger women, but EDs do occur in midlife/older adults, and the incidence of EDs among older women may be increasing. The present study sought to examine outcomes for patients with anorexia nervosa needing to weight restore across four age groups: under 18, 18-25, 26-39, and 40+. Based on prior research, it was hypothesized that there would be no differences between the age groups in percent of expected body weight (%EBW) gained during treatment.

Misuse of Prescribed and Nonprescribed Substances Among U.S. Cancer Survivors.

Background: Substance misuse is common among cancer survivors and can negatively impact cancer outcomes.

Methods: We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a history of solid tumor cancer.

Association between a national behavioral weight management program and real-world weight change.

Objective: In a national cohort of Veterans, weight change was compared between participants in a US Department of Veterans Affairs (VA) behavioral weight management program (MOVE!) and matched non-participants, and between high-intensity and low-intensity participants.

Methods: Retrospective cohort study of Veterans with 1 + MOVE! visits in 2008-2017 were matched to MOVE! non-participants via sequential stratification. Percent weight change up to two years after MOVE! initiation of participants and non-participants was modeled using generalized additive mixed models, and 1-year weight change of high-intensity or low-intensity participants was also compared.

Associations Between a Primary Care-Delivered Alcohol-Related Brief Intervention and Subsequent Opioid-Related Outcomes.

Objective: The co-occurrence of unhealthy alcohol use and opioid misuse is high and associated with increased rates of overdose, emergency health care utilization, and death. The current study examined whether receipt of an alcohol-related brief intervention is associated with reduced risk of negative downstream opioid-related outcomes.

Methods: This retrospective cohort study included all VISN-6 Veterans Affairs (VA) patients with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening results (N=492,748) from 2014 to 2019.

Weight gain and eating disorder symptoms among individuals with atypical anorexia nervosa.

Objective: The purpose of this study was to examine the association between weight gain and eating disorder (ED) symptoms among adults receiving treatment for atypical anorexia nervosa (AAN), to determine whether those who had a higher percent of expected body weight (%EBW) at discharge exhibited lower ED symptoms than those who gained less weight, and to compare this group to a matched sample of patients with anorexia nervosa (AN).

Method: Participants were 96 adults receiving treatment at an ED treatment facility between December 2020 and May 2023. The Eating Disorder Examination-Questionnaire (EDE-Q) was completed at admission and discharge, and %EBW was obtained at admission and discharge.

"Terminal anorexia nervosa" may not be terminal: An empirical evaluation.

Gaudiani et al. (2022) presented terminal anorexia nervosa (T-AN) as a potential new specifier to the anorexia nervosa (AN) diagnosis, with criteria including (a) AN diagnosis, (b) age > 30 years, (c) previously participated in high-quality care, and (d) the clear, consistent determination by a patient with decision-making capacity that additional treatment would be futile, knowing death will result. This study's purpose was to empirically examine a subgroup of participants with AN who met the first three criteria of T-AN-and a smaller subset who also met a proxy index of the fourth criterion involving death (TD-AN)-and compare them to an adult "not terminal" anorexia nervosa (NT-AN) group and to a "not terminal" subset 30 years of age or older (NTO-AN).

Comparing eating disorder treatment outcomes of transgender and gender diverse adolescents with those of cisgender adolescents.

Objective: Eating disorder (ED), depression, and anxiety symptoms at admission and discharge were compared, as were admission-to-discharge changes, for transgender and gender diverse (TGD), and cisgender adolescents receiving intensive treatment for EDs.

Method: Participants were 44 TGD and 573 cisgender adolescents admitted to a treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) at admission and discharge.

Eating disorder virtual intensive outpatient program: patient satisfaction according to age group.

The COVID-19 pandemic has required a shift to telehealth services. However, not all patients are similarly satisfied with this shift, with some studies finding that midlife and older adults are less comfortable with telehealth. The current study examined patient satisfaction with a virtual intensive outpatient program (VIOP) for eating disorders (EDs) among 305 adults (ages 18-25, ages 26-39, and ages 40+), and compared adult satisfaction to satisfaction among children/adolescents ( = 33) receiving VIOP treatment between August 2020 and March 2022 from a large ED treatment facility.

Association Between a National Behavioral Weight Management Program and Veterans Affairs Health Expenditures.

Objective: The association between participation in a behavioral weight intervention and health expenditures has not been well characterized. We compared Veterans Affairs (VA) expenditures of individuals participating in MOVE!, a VA behavioral weight loss program, and matched comparators 2 years before and 2 years after MOVE! initiation.

Methods: Retrospective cohort study of Veterans who had one or more MOVE! visits in 2008-2017 who were matched contemporaneously to up to 3 comparators with overweight or obesity through sequential stratification on an array of patient characteristics, including sex.

An examination of adults with atypical anorexia nervosa at admission to treatment at higher levels of care: An attempt to increase diagnostic clarity.

Objective: Anorexia nervosa (AN) is a serious illness with a high mortality rate and multiple physiological complications. The vague definition of atypical AN allows for subjective interpretation. This retrospective study aimed to focus future research on the operational definition of atypical AN by examining four factors associated with atypical AN at admission to higher level of care treatment.

Atypical antipsychotic use does not impact weight gain for individuals with extreme anorexia nervosa: a retrospective case-control study.

Background: There are no U.S. Food and Drug Administration (FDA)-approved medications for the treatment of anorexia nervosa (AN).

An open trial for adults in a residential program for binge eating spectrum disorders.

The current study assessed treatment outcome for 99 adult admissions to a residential program specifically designed for binge eating spectrum disorders (BESD). Participants completed self-report measures at admission, discharge, and 12-month follow-up and were asked to complete blood draws at admission and follow-up. Primary outcomes were eating behaviors; secondary outcomes included comorbid symptoms and physiological variables.

A brief examination of treatment outcomes in higher levels of care for individuals with eating disorders across age groups.

Objective: Although eating disorders (EDs) occur throughout the lifespan, little research has been conducted with midlife/older adults, particularly those in higher levels of care (HLOC). The current study examined outcomes among 2009 patients with EDs receiving HLOC treatment at a large multisite facility between January 2020 and June 2022, across different age groups (ages <18, 18-25, 26-39 and ≥40). It was hypothesised that patients aged 40+ would exhibit less improvement on measures of ED psychopathology and depression than other age groups.

Characterising use of recovery record among a large, transdiagnostic sample of adults with eating disorders across higher levels of care.

Objective: Smartphone applications (i.e., apps) designed to target mental health symptoms have received increasing public and empirical attention, including in eating disorder|eating disorders (EDs) treatment.

Real World Use of Anti-Obesity Medications and Weight Change in Veterans.

Background: Anti-obesity medications (AOMs) can be initiated in conjunction with participation in the VA national behavioral weight management program, MOVE!, to help achieve clinically meaningful weight loss.

Objective: To compare weight change between Veterans who used AOM + MOVE! versus MOVE! alone and examine AOM use, duration, and characteristics associated with longer duration of use.

Design: Retrospective cohort study using VA electronic health records.

Eating Disorder Examination-Questionnaire: Norms for Adults in Higher Levels of Care.

Establishing normative data for questionnaires is essential for the accurate interpretation of scores, given that these norms can vary according to different subpopulations and treatment contexts. The purpose of this study was to establish norms for the Eating Disorder Examination-Questionnaire (EDE-Q) among adults receiving higher levels of care (HLOCs) for the treatment of eating disorders. Participants were 2,283 people receiving treatment at the inpatient, residential, partial hospitalization, or intensive outpatient levels of care.

Association between patient-reported social and behavioral risks and health care costs in high-risk Veterans health administration patients.

Objective: Social risks complicate patients' ability to manage their conditions and access healthcare, but their association with health expenditures is not well established. To identify patient-reported social risk, behavioral, and health factors associated with health expenditures in Veterans Affairs (VA) patients at high risk for hospitalization or death.

Data Sources, Study Setting, And Study Design: Prospective cohort study among high-risk Veterans obtaining VA care.

Association of Unmet Social Needs With Metformin Use Among Patients With Type 2 Diabetes.

Objective: To evaluate the relationship between social needs and metformin use among adults with type 2 diabetes (T2D).

Research Design And Methods: In a prospective cohort study of adults with T2D (n = 722), we linked electronic health record (EHR) and Surescripts (Surescripts, LLC) prescription network data to abstract data on patient-reported social needs and to calculate metformin adherence based on expected refill frequency using a proportion of days covered methodology.

Results: After adjusting for demographics and clinical complexity, two or more social needs (-0.

Empirical Investigation of Different Factor Structures for the Eating Disorder Examination-Questionnaire in Adult Women With Anorexia Nervosa.

The Eating Disorder Examination-Questionnaire (EDE-Q) is a widely used self-report measure of eating pathology. Despite widespread use, investigations of its factor structure have proved inconclusive and rarely supported the "original" interpretation. The current study evaluates several proposed factor solutions of the EDE-Q using latent variable analysis in a sample of adult women with anorexia nervosa (AN).