Effectiveness of delivering evidence-based eating disorder treatment via telemedicine for children, adolescents, and youth

Barriers limit access to eating disorder treatment. Evidence-based treatment delivered using telemedicine could expand access. This study determined the effectiveness of enhanced Family-Based Treatment (FBT+) delivered using telemedicine for children and adolescents with eating disorders. Participants had a confirmed eating disorder diagnosis, lived in states where treatment was available, and lived with a family member willing to participate. Virtual FBT+ was administered by a five-person team including a therapist, dietitian, medical provider, peer mentor, and family mentor for up to 12 months. Measures were recorded at baseline and varying frequencies throughout treatment. Weight was self-reported. Eating disorder symptoms were assessed with the Eating Disorder Examination-Questionnaire Short Form (EDE-QS) and depression and anxiety were measured using the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). Caregiver burden and self-efficacy were measured using the Burden Assessment Scale, and Parent Versus Eating Disorder scale. The majority of patients (N = 210; 6 to 24 years old [mean 16 center dot 1 years]) were cisgender female (83%) White, (71%), required weight restoration (78%), and had anorexia nervosa, restricting type (63%). After 16 weeks, patients on weight restoration gained on average 11 center dot 3 [9 center dot 86, 12 center dot 8] pounds and the average change in EDE-QS score was -6 center dot 31 [-8 center dot 67, -4 center dot 10] points. Similar reductions were seen for depression (-2 center dot 62 [-4 center dot 24, -1 center dot 04]), anxiety (-1 center dot 44 [-1 center dot 12, 0 center dot 78]), and caregiver burden (-4 center dot 41 [2 center dot 45, 6 center dot 31]). Caregiver self-efficacy increased by 4 center dot 56 [3 center dot 53, 5 center dot 61] points. Patients and caregivers reported satisfaction with treatment. Virtual FBT+ for eating disorders can transcend geographical and psychosocial treatment barriers, expanding access to evidence-based eating disorder treatment.