A Naturalistic Study of Virtual Versus In-Person Intensive Outpatient Treatment for Eating Disorders During the COVID-19 Pandemic in United States Based Treatment Facilities (Preprint)

BACKGROUND While virtual therapy has been found to be effective in treating eating disorders (EDs), little work has examined virtual therapy at higher levels of care. OBJECTIVE The purpose of the current study was to add to the limited research on in-person versus virtual treatment at a higher level of care by comparing treatment outcomes between an in-person intensive outpatient program (IOP) and a virtual IOP (VIOP) for patients with EDs. METHODS Patients receiving treatment who completed both admission and discharge questionnaires in VIOP treatment (N = 231) and in-person IOP treatment (N = 39) between 2021 and mid-2022 within a large ED healthcare system were included in the study. Welch’s t-tests on admission, discharge, and raw change scores were conducted. Adjusted logistic regressions were conducted predicting treatment program (VIOP vs. IOP) from residualized change in each outcome. RESULTS VIOP patients were significantly older (M=28.03, SD=11.09) than IOP patients (M=19.51, SD=6.98) and had significantly different numbers of ED diagnoses, but no differences were observed for race or gender. VIOP patients did not exhibit significantly different improvements in ED symptom scores or depression scores when compared to IOP patients, controlling for age, diagnosis, and admission scores. CONCLUSIONS No evidence suggested ED or depression outcomes were different for patients receiving VIOP treatment versus IOP treatment. Moreover, no evidence suggested VIOP treatment was more likely to exacerbate disparities in treatment access for non-white or older adults. These results suggest VIOP treatment may improve treatment access in an equitable fashion without reducing treatment quality.