Does it matter how quickly eating disorder symptoms resolve once you start therapy? Yes, it absolutely does.
Columbus Park, an outpatient facility treating disorders throughout New York state, announced their Early Change Model for the treatment of eating disorders and shared data that supports the link between optimal treatment outcomes and early change in their patients.
The Importance of Early Change for Long-Term Outcome
An abundance of evidence accumulated over the last 20 years reinforces that early change in treatment is a “robust” predictor of a good long-term outcome.1 In other words, those who experience symptom improvement within the first few weeks of treatment fare better overall. As an example, if a patient experiences a reduction in binge eating or purging—or in the case of anorexia nervosa, an increase in weight—over the first four to eight weeks of treatment, chances are that patient will continue to progress and will most likely sustain this progress long term.
On average, compared to patients who see slower change at the start of treatment, rapid responders:
- Need significantly fewer treatment sessions
- Show lower scores on symptom measures after treatment ends
- Are twice as likely to achieve full eating disorder recovery
- Are more likely to sustain recovery over time
Columbus Park’s Early Change Model
Columbus Park patient data from April 2015-June 2022 illustrates the connection between early change and outcome at 20 sessions into treatment (a typical treatment term at Columbus Park). In this data, a decrease in global distress is the indicator of change. Global distress correlates with eating disorder symptoms, depression, anxiety, PTSD, problems with attention, low quality of relationships, day-to-day functioning, and workplace productivity.
In the graph above, the blue line shows that early change patients generally experienced a decrease in global distress to non-clinical levels by session five, and their progress tended to hold steady for the remaining sessions. The orange line shows patients who did not experience early change, with the treatment impact on global distress being much more modest—a less ideal outcome. Around 71 percent of CP clients experienced early change, and 29 percent did not. This early change, predicting strong outcomes at the end of treatment, also correlates with a relatively short treatment duration, averaging 20 weeks.
According to Melissa Gerson, LCSW, Columbus Park’s Founder and Clinical Director, “In spite of such well-established and repeated findings in the research telling us that early change influences both short and long-term treatment outcomes, the mechanisms of this change are still not well understood. In other words, we can see that rapid responders fare better, but a) we’re not sure why some patients respond quickly to eating disorder treatment, and others do not, and b) the research to date hasn’t uncovered the specific factors within treatment that drive early change for some patients. While we can’t say with certainty why our patients are faring as well as they are, we do have some hypotheses. Over the last five to eight years, in particular, our team has isolated specific treatment strategies that foster early change and consequently, better outcomes. We’ve also gotten really good at assessing patient clinical features and personality characteristics, so we know whether to move forward with first-line treatments or if we need to take a different course.”
Larger Implications for Other Mental Illnesses
Early change in treatment is relevant beyond eating disorders, as we see the link between early change and positive short and long-term outcomes in a wide range of mental health diagnoses, including treatment for common conditions like depression and anxiety. As the strongest prognostic indicator in the eating disorder field, treatment providers should be focused on the early weeks of treatment and shaping interventions to increase the likelihood of prompt change.
To read the original press release, click here.
Reach out to the team at Columbus Park to learn more about our highly effective evidence-based approach to eating disorder treatment.
1 Graves, T. A., Tabri, N., Thompson-Brenner, H., Franko, D. L., Eddy, K. T., Bourion-Bedes, S., Brown, A., Constantino, M. J., Flückiger, C., Forsberg, S., Isserlin, L., Couturier, J., Karlsson G. P., Mander, J., Teufel, M., Mitchell, J. E., Crosby, R. D., Prestano, C., Satir, D. A., Simpson, S., Sly, R., Lacey, J. H., Stiles-Shields, C., Tasca, G. A., Waller, G., Zaitsoff, S. L., Rienecke, R., Le Grange, D., Thomas, J. J. (2017). A meta-analysis of the relation between therapeutic alliance and treatment outcome in eating disorders. International Journal of Eating Disorders, 50(4), 323–340. https://doi.org/10.1002/eat.22672