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Two Year Follow-Up of the MOSAIC Trial: a Multi-Centre Randomised Controlled Trial Comparing Two Psychological Treatments in Adult Outpatients with Broadly Defined Anorexia Nervosa

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Ulrike Hermine Schmidt, Elizabeth Gabrielle Ryan, Savani Bartholdy, Bethany Gwen Renwick, Alexandra Jane Keyes, Caitlin Beth O'Hara, Jessica Kate McClelland, Anna Lose, Martha Kenyon, Hannah DeJong, Hannah Broadbent, Rachel Loomes, Lucy Serpell, Lorna Richards, Eric Johnson-Sabine, Nicky Boughton, Linette Whitehead, eva-maria bonin, Jennifer Beecham, Sabine Landau & 1 more Janet Linda Treasure

Original languageEnglish
Pages (from-to)793-800
JournalInternational Journal of Eating Disorders
Issue number8
Early online date6 Apr 2016
Accepted/In press1 Feb 2016
E-pub ahead of print6 Apr 2016
PublishedAug 2016


  • Two Year Follow-Up of_SCHMIDT_Accepted 1Feb2016_GREEN AAM

    2_year_follow_up_paper_final_IJED_with_second_round_of_revisions_20102016.docx, 69.1 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:23 Feb 2016

    Version:Accepted author manuscript

    This is the peer reviewed version of the following article: Schmidt, U., Ryan, E. G., Bartholdy, S., Renwick, B., Keyes, A., O'Hara, C., McClelland, J., Lose, A., Kenyon, M., Dejong, H., Broadbent, H., Loomes, R., Serpell, L., Richards, L., Johnson-Sabine, E., Boughton, N., Whitehead, L., Bonin, E., Beecham, J., Landau, S. and Treasure, J. (2016), Two-year follow-up of the MOSAIC trial: A multicenter randomized controlled trial comparing two psychological treatments in adult outpatients with broadly defined anorexia nervosa. Int. J. Eat. Disord., 49: 793–800, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

King's Authors


Objective: This study reports follow-up data from a multi-centre randomized controlled trial (n=142) comparing the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) with Specialist Supportive Clinical Management (SSCM) in outpatients with broadly defined anorexia nervosa (AN). At 12 months post-randomization, all patients had statistically significant improvements in body mass index (BMI), eating disorder (ED) symptomatology and other outcomes with no differences between groups. MANTRA was more acceptable to patients. The present study assessed whether gains were maintained at 24 months post-randomization.

Methods: Follow-up data at 24 months were obtained from 73.2% of participants. Outcome measures included BMI, ED symptomatology, distress, impairment, and additional service utilization during the study period. Outcomes were analyzed using linear mixed models.

Results: There were few differences between groups. In both treatment groups, improvements in BMI, ED symptomatology, distress levels and clinical impairment were maintained or increased further. Estimated mean BMI change from baseline to 24 months was 2.16kg/m2 for SSCM and 2.25kg/m2 for MANTRA (effect sizes of 1.75 and 1.83 respectively). Most participants (83%) did not require any additional intensive treatments (e.g. hospitalization). Two SSCM patients became overweight through binge-eating.

Discussion: Both treatments have value as outpatient interventions for patients with AN.

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