Consider these four facts:
- Eating disorders affect 9% of the U.S. population (30 million people)
- Eating disorders are the second deadliest mental illness, behind only opioid addiction
- Weight gain early in treatment is considered a primary predictor of success with FBT, which is the gold-standard treatment for young people
- Nutrient needs of patients are complex and non-intuitive
Taken together, these facts make it clear just how important weight gain is to lasting recovery. And yet, there is no data on dietary interventions used in eating disorder treatment. A variety of different approaches are used in practice, and research is sparse on which may be the most effective. This gap was the impetus behind Equip’s latest “Renourish” study.
The Renourish study, which began in the spring of 2022, is Equip’s first randomized trial, and the first study (to our knowledge) to compare virtually delivered dietary interventions commonly used in eating disorder treatment.
We enrolled 100 patients aged 6-24 with a diagnosis of either anorexia nervosa (AN) or avoidant/restrictive food intake disorder (ARFID), and had self-selected for virtual eating disorder treatment. Upon admission, patients were assigned to receive one of two dietary interventions:
- Calorie-based: Caregivers are provided a daily calorie goal by their registered dietitian. .
- Plate-by-Plate™: This is a visual approach, designed for FBT, whereby caregivers are asked to follow a series of simple steps to assemble a plate that is “normal,” with representation of most/all food groups and emphasis on variety. Counting calories and weighing are discouraged.
The primary objective of the study is to examine any potential differences in weight changes across the two groups during the first sixteen weeks of treatment. We’re also looking at other outcomes, such as eating disorder symptoms, anxiety, depression, and caregiver burden. Interviews were conducted with both caregivers and clinicians (RDs) to assess their experience with each approach.
Data analysis is not yet complete (but will be soon—stay tuned for our Renourish Outcomes paper, which will follow in a few months!), but you can read more about the Renourish study through our protocol paper here. The findings will help us better understand (1) effectiveness and acceptability of dietary interventions commonly used in FBT, and (2) the needs of the families we’re serving here at Equip.
- Hellner M, Steinberg D, Baker JH, Blanton C. Digitally Delivered Dietary Interventions for Patients with Eating Disorders Undergoing Family-Based Treatment: Protocol for a Randomized Feasibility Trial. JMIR Res Protoc 2023;12:e41837. doi: 10.2196/41837