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Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID-19 pandemic

Research output: Contribution to journalArticlepeer-review

Anna Carr, Cindy Toloza, Zhuo Li, Bruno Palazzo Nazar, Hubertus Himmerich

Original languageEnglish
Article numbere2604
JournalBrain and Behavior
Issue number6
PublishedJun 2022

Bibliographical note

Funding Information: informationNational Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London; Maudsley NHS Foundation Trust (SLaM); King's College LondonThe authors would like to thank all the patients and clinicians who contributed to the present study. The study did not receive specific funding. HH has received salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London. Publisher Copyright: © 2022 The Authors. Brain and Behavior published by Wiley Periodicals LLC.

King's Authors


Objective: The current research aimed to compare clinical outcome measures of two National Eating Disorder (ED) Day Services at the Maudsley Hospital from before the COVID-19 lockdown, when treatment was face to face, with after the lockdown when treatment moved online. Method: Clinical outcome measures collected as part of the admission and discharge process were compared from the beginning and end of treatment for patients treated either via face-to-face or online delivery. Twenty-nine patients’ data were analyzed (89% of them female, 11% male, 89% from White ethnic backgrounds, 11% from BAME ethnic backgrounds and a mean age of 25.99 years). Additionally, the mean change in outcome measures was also compared between the two groups (pre-lockdown face to face and during lockdown online). Results: Treatment delivered face to face led to significant improvements in body mass index (BMI) but not in Eating Disorder Examination Questionnaire (EDEQ) Global and Work and Social Adjustment Scale (WSAS) Total scores. In contrast, treatment delivered online led to significant improvements in EDEQ Global and WSAS Total scores but not in BMI. Neither one of the delivery modalities created significantly larger mean changes in any of the clinical outcome measures than the other. Conclusions: Both face-to-face and online delivery of eating disorder day treatment show some success. Suggested improvements for using online delivery of treatment include implementing additional support opportunities, adapting the online format to improve communication and commitment and using a hybrid model of specific face-to-face elements with some online treatment.

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