Mediators of Weight Gain in Acute Treatment of Patients with Anorexia Nervosa

Anorexia Nervosa has been associated with low levels of readiness to recover since the earliest accounts of the disorder. Given the motivational deficiency and egosyntonic quality, anorexia nervosa is among the most difficult types of psychological disorders to treat. Recent empirical and theoretical investigations have focused on the long-term outcome of weight gain from readiness to change. However, few studies have analyzed the bidirectional relationship of readiness to change and weight gain during the course of hospitalization. The aims of the present study were to analyze the short-term bidirectional relationship between readiness to change and weight gain at multiple time points during acute hospitalization, and to evaluate the influence of stronger cognitive distortions at admission on the relationship between recent weight gain and readiness to change. The sample consisted of 30 females and 3 males diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, with weight below 93 percent of their healthy weight range, and who were admitted to an inpatient facility. At admission, the patients were administered self-report measures assessing readiness to change and cognitive distortions. Additionally, patients completed a self-report measure evaluating readiness to change every two weeks following admission. This study found that during the last weeks of hospitalization, readiness to change predicted weight gain one day following the completion of the self-report measure. However, despite the expectation that greater prior weight gain would predict lower readiness to change, no such relationship emerged. Additionally, the severity of cognitive distortions at admission was not found to predict a stronger negative relationship between prior weight gain and readiness to change. These results suggest that readiness to change can be utilized to predict short-term weight gain at multiple time points during the latter part of hospitalization for treatment of anorexia nervosa. This information has implications for the clinical care of severely underweight patients with eating disorders.