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Int J Eat Disord. 2018 Sep;51(9):1051-1055. doi: 10.1002/eat.22899. Epub 2018 Sep 6.

A path to defining excellence in intensive treatment for eating disorders.

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Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Neuropsychiatric Research Institute, Fargo, North Dakota, U.S.A.
Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, U.S.A.
Department of Psychiatry, University of California San Diego, San Diego, California.
Department of Psychiatry, Columbia University Medical Center, New York, New York, U.S.A.
Department of Psychiatry Weill Cornell Medical College, New York, New York, U.S.A.


In the United States, the past decade has seen rapid growth in treatment centers providing specialty care to patients with eating disorders. Much of this growth has been in higher levels of care, including hospital-based and residential treatment. Despite this expansion, there remains lack of agreement regarding the most important components of care, such as staff training or specifics of treatment delivery. Additionally there is no consensus on how best to assess outcome and compare performance across programs. This leaves patients, families, public and private insurance programs, and policy makers with limited information to help facilitate treatment decisions. The present paper considers implications of these changes in the eating disorder treatment landscape and examines two ideas that, if implemented, may enhance the quality of eating disorder care. First, we explore the proposal to develop a network of centers of excellence in eating disorder treatment and the value this may have for improving overall treatment quality. This idea was discussed at an expert meeting held at SAMSHA in 2017 regarding issues important to the field following passage of the 21st Century Cures Act. Second, we consider the potential utility of a study using the Delphi method to promote expert consensus regarding clinical outcome assessments.


anorexia nervosa; center of excellence; eating disorders; inpatient; intensive treatment; outcome; residential treatment

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