Title: Virtually Delivered Eating Disorder Treatment using
an Enhanced Multidisciplinary Care Team:
A Case Study
Running Title: Enhanced Virtual Eating Disorder Treatment
Authors and Affiliations:
Megan Hellner, DrPH, MPH, RD, Equip Health, San Diego, CA
Cara Bohon, PhD, Equip Health, San Diego, CA; Stanford University School of Medicine, Stanford, CA
Samuel Kolander, MD, Equip Health, San Diego, CA; New York State Psychiatric Institute, New York, NY
Erin Parks, PhD, Equip Health, San Diego, CA
Word Count (Abstract): 200 Word Count (Manuscript): 1994
Data Availability Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Conflict of Interest Statement: The authors have no conflict to declare.
Abstract:
Objective: While family based treatment (FBT) is the recommended treatment for adolescents and young adults with eating disorders, it is often not geographically accessible, and outcomes can be negatively impacted by misalignment between treatment providers. The aim of this case report is to describe outcomes of two patients treated virtually with an augmented team approach to provide preliminary evidence of feasibility and efficacy. Methods: Two patients were enrolled at Equip for 4 weeks of treatment. Engagement and outcomes were assessed before, after, and at 4 week follow-up. Sessions were held via telehealth with four providers (therapist, dietitian, peer mentor and family mentor). Results: Patient one gained 6.4 lbs, and patient two gained 4.2 lbs during the trial. Eating disorder symptom scores also decreased for each patient. Patients attended 18 and 16 total sessions respectively, and parents and patients reported that they would “definitely recommend” the treatment to a friend or family, suggesting strong acceptability. Weight gain continued for both patients at 4 week follow-up (2 lbs and 4.8 lbs respectively).Discussion: These findings offer preliminary support for this treatment resulting in meaningful clinical improvements. Future research should examine this treatment in larger samples, with longer follow-up periods and comparison treatments.
Keywords: Telemedicine, Family Therapy, Adolescents, Anorexia Nervosa, Feeding and Eating Disorders, Mentors
Key Clinical Message: Both patients experienced meaningful clinical improvements with this virtual approach and the augmented treatment team in regards to weight gain, acceptability and clinical assessment scores. These findings offer preliminary support for this model.
Introduction:
Eating Disorders are life-threatening conditions characterized by a marked disturbance in how one experiences weight (DSM-V).  Further, eating disorders have the second highest standardized mortality rates of all psychiatric illnesses (Chesney et al., 2014). Family-based treatment (FBT) is well established as the gold standard treatment for anorexia nervosa (AN) (Couturier, 2013). Delivery of FBT requires use of a specialized provider trained in the approach, which presents a challenge for families residing in ‘treatment deserts’ without access to specialized services.