Exploring the preliminary effectiveness and acceptability of food-based exposure therapy for eating disorders: A case series of adult inpatients

Abstract

Although exposure therapy is effective in reducing eating-related fears and avoidance in individuals with eating disorders (EDs), there has been little study of this treatment in inpatient settings. To address this gap, we conducted a case series to evaluate the effects of a food-based exposure therapy intervention on eating-related fears and avoidant behaviors among adults being treated for an ED in an inpatient hospital setting. Patients (N = 106) were provided psychoeducation on the treatment approach, aided in the development of an exposure hierarchy containing fear-evoking stimuli related to eating (e.g., feared foods), and guided in completing exposure exercises and gradually progressing through the hierarchy. Results showed that patients experienced significant reductions in eating-related fears and avoidant behaviors from pretreatment to posttreatment. Acceptability of the intervention was reasonably well-established by (a) acceptable rates of treatment participation and completion, (b) favorable ratings of the intervention provided in a posttreatment satisfaction survey, and (c) the absence of any exacerbations in the frequency of compensatory weight control behaviors (e.g., self-induced vomiting) over the course of treatment. Clinical implications of these findings are discussed in the light of clinicians’ concerns about and underutilization of food-based exposure therapy for EDs, particularly in inpatient settings.