Weight gained during treatment predicts 6‐month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.

Objective: This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Methods: Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data...

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Published in:International Journal of Eating Disorders Vol. 57; no. 8; pp. 1653 - 1668
Main Authors: Frank, Guido K. W., Stoddard, Joel J., Brown, Tiffany, Gowin, Josh, Kaye, Walter H.
Format: Article
Published: Wiley-Blackwell Aug2024
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Aug2024
      vid: 57
      iid: 8
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      pub: Wiley-Blackwell
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        10.1002/eat.24208
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        atl: Weight gained during treatment predicts 6‐month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.
      aug:
        au:
          Frank, Guido K. W.
          Stoddard, Joel J.
          Brown, Tiffany
          Gowin, Josh
          Kaye, Walter H.
        affil:
          Department of Psychiatry, University of California San Diego, San Diego California,, USA
          Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora Colorado,, USA
          Department of Psychological Sciences, Auburn University, Auburn Alabama,, USA
          Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora Colorado,, USA
      su:
        Patients
        Hospital admission & discharge
        Hospital care
        Anorexia nervosa treatment
        Random forest algorithms
        Body mass index
        Prediction models
        Research funding
        Treatment effectiveness
        Descriptive statistics
        Discharge planning
        Longitudinal method
        Comparative studies
        Length of stay in hospitals
        Weight gain
      sug:
        subj:
          Patients
          Hospital admission & discharge
          Hospital care
          Anorexia nervosa treatment
          Random forest algorithms
          Body mass index
          Prediction models
          Research funding
          Treatment effectiveness
          Descriptive statistics
          Discharge planning
          Longitudinal method
          Comparative studies
          Length of stay in hospitals
          Weight gain
      keyword:
        anorexia nervosa
        body mass index
        machine learning
        weight
        anorexia nervosa
        body mass index
        machine learning
        weight
      ab: Objective: This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Methods: Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6‐month follow‐up analysis. Participants were treated in a 6‐day‐per‐week partial‐hospital program. Participants were assessed for eating disorder‐specific and non‐specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. Results: The models predicting body mass index (BMI) at 6‐month follow‐up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6‐month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r =.51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6‐month follow‐up (r =.55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z‐transformed BMI in the adolescent‐only group. Length of stay was most predictive of weight gain in treatment (r =.56) but did not predict longer‐term BMI. Conclusions: This study, using an agnostic ensemble machine learning approach in the largest to‐date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer‐term weight‐related outcomes. Other potential predictors, personality, mood, or eating disorder‐specific symptoms were relatively much less predictive. Public Significance: The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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