Maintenance of symptoms and weight-related gains following residential eating disorder treatment at discharge and one-year follow-up

Eating disorders (EDs) are severe conditions with high relapse rates. Residential treatment may support recovery, yet long-term outcomes require further evaluation. This study examined changes in psychological symptoms and weight-related outcomes from intake to discharge and one-year follow-up in 275 female adolescents and adults admitted to a residential ED program. Participants completed measures of ED symptoms, anxiety, depression, and weight (BMI or %mBMI for adolescents) at each timepoint. Multilevel modeling, reliable change index (RCI), and clinically significant change (CSC) analyses evaluated symptom trajectories and treatment response. Adolescents and adults demonstrated large, clinically meaningful group-level improvements from intake to discharge across ED symptoms, anxiety, depression, and BMI. While small rebounds occurred between discharge and follow-up, net gains were substantial (p’s < .001). Adults presented with more severe ED and anxiety symptoms than adolescents, but these differences were no longer significant by one-year follow-up. RCI/CSC analyses indicated that approximately 30–50% of the participants maintained clinically significant improvements at one-year follow-up on various outcomes. Most participants (70.9%) did not return to inpatient hospitalization or residential treatment within the year following discharge. Overall, residential treatment was associated with meaningful group-level symptoms and weight improvements that were generally sustained over a year, with substantial individual-level variation, providing additional data for its role in supporting ED recovery.