Table 1 Family-based treatment – anorexia nervosa
From: Canadian practice guidelines for the treatment of children and adolescents with eating disorders
Certainty assessment | Impact | Certainty | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|
№ of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
FBT vs supportive/dynamic individual– outcomes - Remission (assessed with: attaining target weight, good outcome category) Weight gain | |||||||||
3 | randomised trials | not serious | not serious | not serious | not serious | none | One meta-analysis indicated superiority of FBT at 6- and 12- month follow up. Three RCTs 43/90 (47.8%) with good outcome or in full remission with FBT, compared to 26/89 (29.2%) in Individual group. Total n = 179. | ⨁⨁⨁⨁ HIGH | CRITICAL |
not serious | not serious | not serious | not serious | none | Weight gain greater in the FBT group compared to individual therapy group at end of treatment. | ⨁⨁⨁⨁ HIGH | CRITICAL | ||
RCT (FBT vs CBT) Remission/Good Outcome (assessed with: Morgan Russell Scale) | |||||||||
1 | randomised trials | not serious | not serious | not serious | not serious | none | 7/13 (53.8%) had a good outcome in FBT group vs. 7/12 (58.3%) in the CBT group. No significant difference. | ⨁⨁⨁⨁ HIGH | CRITICAL |
Weight Gain (assessed with: kg and %IBW) | |||||||||
1 | Case control | serious b | not serious | not serious | not serious | none | One case control retrospective chart review. 32 treated with FBT model compared to 14 in nonspecific therapy. Those in FBT made greater gains in weight. | ⨁◯◯◯ VERY LOW | CRITICAL |
Weight (assessed with: kg) | |||||||||
7 | Case series | very serious a,b | not serious | not serious | not serious | none | 7 large case series (total n = 223). Of these, 32 were children under age 13. Weight was significantly improved, pre to post. | ⨁◯◯◯ VERY LOW | CRITICAL |
Weight (assessed with: kg) | |||||||||
11 | Case reports | very serious a,b | not serious | not serious | not serious | none | 11 case reports detailing 29 patients who restored weight with FBT. Some described twins, comorbid conversion disorder, FBT within a group home setting, or FBT starting on a medical unit or use of FBT combined with medication. | ⨁◯◯◯ VERY LOW | CRITICAL |