Table 5 FBT adaptations for children and adolescents with 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 | |||
| Weight and Psychological Symptoms | |||||||||
| 1 | randomised trials 10 vs 20 sessions | not serious | not serious | not serious | not serious | none | RCT comparing 10 sessions of FBT to 20 sessions of FBT (n = 86). No differences in weight seen at 1 year. Those with nonintact families and severe eating related obsessive-compulsive features fair better in FBT. | ⨁⨁⨁⨁ HIGH | IMPORTANT |
| not serious | not serious | not serious | not serious | none | No differences in psychological symptoms (EDE) seen at 1 year. Those with nonintact families and severe eating related obsessive-compulsive features fair better in FBT. | ⨁⨁⨁⨁ HIGH | IMPORTANT | ||
| 1 | randomised trials Adaptive vs. Standard FBT | not serious | not serious | not serious | not serious | none | 45 adolescents in RCT comparing Adaptive FBT (3 extra sessions) to Standard FBT. No differences in outcomes in terms of weight. | ⨁⨁⨁⨁ HIGH | CRITICAL |
| 1 | Randomized trial FBT +/− family meal | not serious | not serious | not serious | not serious | none | One RCT examined FBT with and without the family meal intervention (n = 23). No differences were found in weight at the end of the study. | ⨁⨁⨁⨁ HIGH | CRITICAL |
| 1 | randomised trials FBT alone vs. FBT plus parent consultation | not serious | not serious | not serious | not serious | none | RCT of 20 adolescents aged 12–16 all female. 10 received FBT plus parent to parent consultation and 10 received FBT alone. Small increase in rate of weight restoration was seen in FBT plus consultation group. | ⨁⨁⨁⨁ HIGH | CRITICAL |
| Weight | |||||||||
| 4 | Case Series guided self help, short term intensive, telemedicine | very serious a,b | not serious | not serious | not serious | none | Uncontrolled feasibility study looked at Parental guided self help FBT for AN (n = 19). Improvement in weight was seen at the end of the study. Uncontrolled Short-Term Intensive Family Based Treatment for AN (n = 19). 18/19 patients gained and maintained weight. 30 month outcome of 74 patients treated with this Short Term Intensive Modal indicated 61% remained in full remission. One case series (n = 10) showing benefit of FBT delivery via telemedicine. | ⨁◯◯◯ VERY LOW | CRITICAL |
| Weight | |||||||||
| 1 | Case Report telemedicine | very serious a,b | not serious | not serious | not serious | none | One case report of FBT delivered by telehealth. Weight improved pre to post treatment. | ⨁◯◯◯ VERY LOW | CRITICAL |