How effective is outpatient care compared to inpatient care for the treatment of anorexia nervosa? a systematic review

Objective: To review systematically inpatient compared to outpatient care for the treatment of anorexia nervosa and other eating disorders. Method: Search of electronic databases, references and contact with experts to identify randomized controlled trials (RCTs), case–control studies and case series. Study quality was assessed and data extracted by two independent researchers. Results: Two RCTs and seven case series were identified. Unpublished 5‐year follow‐up data from one RCT showed a (non‐statistically significant) improvement in percentage well in the outpatient compared to the inpatient group, but no difference in mortality. Case series were difficult to interpret because of the inherent biases – follow‐up varied from 1.5 to 11.7 years and showed wide variations in outcome. Discussion: There is no evidence that inpatient treatment is more (or less) effective than outpatient treatment for people with anorexia nervosa in the long term. Short‐term emergency inpatient treatment of the consequences of eating disorders may still be necessary.