Acceptability and tolerability of a meal-based, rapid refeeding, behavioral weight restoration protocol for anorexia nervosa.

Objective: Safe, tolerable, effective approaches to weight restoration are needed for adults with anorexia nervosa (AN). We examined weight outcomes and patient satisfaction with an integrated, inpatient-partial hospitalization, meal-based behavioral program that rapidly weight restores a majority of patients.

Method: Consecutively discharged inpatients (N = 149) treated on weight gain protocol completed an anonymous questionnaire assessing treatment satisfaction at inpatient discharge. Responders (107/149) rated their satisfaction with program components, feeling included in treatment, and likelihood of returning, or recommending the program to others. Clinical and demographic data were abstracted by chart review on all cases.

Results: Over 70% of adult patients met BMI≥19 kg/m by program discharge. Mean inpatient rate of gain was 1.85 kg/week (SD = 0.89). A majority (83.2%) would recommend the program to others and 71.4% endorsed a willingness to return if needed. The behavioral treatment focus was rated highly by 82.9% of respondents and was the strongest predictor of likelihood of referring others.

Discussion: Results indicate a behaviorally focused, integrated, meal-based specialty program for eating disorders that includes rapid weight gain is acceptable to most participants. Data have implications for quality care, outcome reporting, and cost-effectiveness of inpatient behavioral weight restoration programs for individuals with AN.