Psychological variables impacting weight gain rapidity in adolescents hopitalized with eating disorders

Eating disorders are associated with a variety of pervasive consequences and often necessitate immediate treatment that focuses on medical and psychological improvement. With the high cost of hospitalization, treatment facilities are experiencing increased pressure to quickly and effectively treat these disorders, though past studies have concluded that the psychological symptoms associated with eating disorders are slow to resolve. While there are multiple studies on outcome in eating disorder patients, very few studies have evaluated psychological variables as predictors of weight gain rapidity and duration of hospitalization among hospitalized adolescents. The aims of the present study were to identify what psychological variables at admission predicted rapidity of weight gain and duration of hospitalization and to evaluate what psychological variables improved during acute treatment. The sample consisted of 38 patients who were hospitalized for an eating disorder and were found to be below 93 percent of their healthy weight range. Upon admission, patients completed self-report measures assessing the following psychological variables: self-esteem, self-efficacy, perfectionism, readiness to change, emotion regulation, and cognitive distortions. Patients completed these measures again when reaching 85 percent of their ideal body weight (n = 29), if applicable, and once more upon discharge (n = 33). This prospective investigation revealed that self-efficacy, emotion regulation, and self-esteem at admission predicted time to reach 85 percent ideal body weight. Readiness to change at admission and, self-esteem at trend level, were predictive of duration of hospitalization. Several aspects of psychological functioning were found to significantly improve over the course of treatment, with readiness to change increasing and both perfectionism and cognitive distortions decreasing. Despite significant improvement in these psychological variables and in weight gain, no relationship was found between these changes. These results suggest that certain psychological factors can be utilized to predict weight gain x rapidity and duration of hospitalization for treatment of eating disorders. Additionally, there is significant improvement in both weight restoration and psychological functioning over the course of acute treatment. This information has important implications in identifying psychological severity of eating disorder, potential weight gain prognosis in treatment and determining specific treatment goals.