The Importance of Specialized Inpatient Medical Stabilization for Weight Restoration of Individuals with Extreme Eating Disorders

Abstract

Inpatient care is a significant contributor to the health-care costs associated with the treatment of individuals with eating disorders (EDs). This study seeks to better understand the treatment outcomes of individuals with extreme EDs requiring inpatient medical stabilization at specialized medical versus nonspecialized medical units. Patients transferred via air ambulance to ACUTE Center for Eating Disorders and Severe Malnutrition (specialized care) from an outside hospital (nonspecialized care) between January 2022 and March 2024 were included in this retrospective, non-randomized cross-over trial. Weekly weight trends, length of stay, unit on which patients received medical care, and development of medical complications after admission were compared between the nonspecialized the specialized inpatient medical stabilization units.

Final analysis included 92 patients. Those with restricting EDs experienced an average of -0.9 kg/week of weight gain while receiving nonspecialized medical care, compared to 1.6 kg/week of weight gained at the specialized medical stabilization unit. Individuals with purging EDs experienced an average of -0.2 kg/week weight change at the nonspecialized medical units compared to 1.7 kg/week gained at the specialized unit, after excluding patients who developed complications related to improper fluid management. Patients were also more likely to be treated in an intensive care unit and develop increased iatrogenic complications while receiving nonspecialized medical treatment compared to those patients treated on a specialized ED unit. Specialized, inpatient medical care for those with extreme EDs is associated with positive weight trends and reduced rates of iatrogenic complications, compared to nonspecialized inpatient medical care.