Multifamily therapy for adolescent eating disorders: a study of the change in eating disorder symptoms from start of treatment to follow-up

J Eat Disord. 2023 Jun 7;11(1):92. doi: 10.1186/s40337-023-00814-y.

Abstract

Background: This study aimed to evaluate multifamily therapy (MFT) for adolescents with eating disorders (EDs) in a clinical setting, by presenting the outcome of families participating in this treatment at a specialist ED service. MFT was an adjunct to treatment at local mental health services. In particular, the study aimed to present the change in eating disorder symptoms and psychological distress from before to after treatment and at a 6 months follow-up.

Methods: Participants were 207 adolescents receiving outpatient MFT (10 or 5 months) at Oslo University Hospital in Norway between 2009 and 2022. Adolescents had heterogeneous ED presentations, with a preponderance of anorexia nervosa (AN) and atypical AN. All participants completed pre- and post-treatment questionnaires [The eating disorder examination questionnaire (EDE-Q) and the strengths and difficulties questionnaire (SDQ)]. 142 adolescents additionally completed the same questionnaires at 6 months follow-up. Weight and height were measured at all time points.

Results: Linear mixed model analyses showed that from start of treatment to follow-up, there was a significant increase in BMI percentile (p < 0.001) and a significant decrease in EDE-Q global score (p < 0.001) and SDQ total score (p < 0.001).

Conclusions: The study shows that adolescents with an eating disorder who received adjunct outpatient MFT in a real world clinical setting, experienced reductions in ED symptoms comparable to that found in a randomized controlled trial.

Trial registration: The data used in this study was collected as part of routine clinical procedures for quality assurance and trial registration is therefore not required.

Keywords: Adolescents; Eating disorders; Multifamily therapy; Outcome.

Plain language summary

Eating disorders are serious psychiatric diseases associated with a significant disease burden. Providing effective treatment is imperative. In multifamily therapy, several families are brought together in multi-family groups to work together to overcome the eating disorder. Research on multifamily therapy suggests that it is effective in treating adolescent eating disorder, but there is a need for studies with larger sample sizes to evaluate how the treatment performs outside controlled research settings. Data were collected from 207 adolescents participating in multifamily therapy at a specialist eating disorder service in Norway. There were significant improvements in eating disorder symptoms and psychological distress from start of treatment to 6 month follow-up. The study shows that adolescents with an eating disorder who received multifamily therapy in a real world clinical setting, experienced reductions in eating disorder symptoms comparable to that found in a randomized controlled trial and in smaller studies from real world settings.