Why Do Patients Drop Out of Eating Disorder Treatment?

"Premature discontinuation of therapy is one of the most significant challenges in the treatment of eating disorders. Despite the development of effective psychological treatments over recent decades, many patients end therapy before achieving clinically meaningful improvement. This has important consequences for both patients and clinical services. Patients who discontinue treatment generally have poorer outcomes than those who complete it, and dropout also represents a waste of valuable therapeutic resources."

"Treatment dropout should not be interpreted solely as a problem of patient motivation, but also as a signal that invites reflection on the characteristics of treatments and the organization of clinical services. Wade and Schmidt describe five main categories of treatment discontinuation, with patient-initiated dropout being primary, where patients may decide to stop therapy because treatment is perceived as too demanding, particularly in cognitive behavioral approaches that require early behavioral changes and tasks between sessions."

Premature discontinuation of therapy represents a major challenge in eating disorder treatment, resulting in poorer patient outcomes and wasted clinical resources. Rather than viewing dropout solely as a patient motivation problem, it should signal the need to examine treatment characteristics and clinical service organization. Wade and Schmidt identify five categories of treatment discontinuation, including patient-initiated dropout driven by demanding treatments, low motivation, weak therapeutic alliance, and logistical barriers. Patients may perceive treatments as too demanding or struggle with the ego-syntonic nature of eating disorders. Engagement strategies such as reducing waitlists, offering patient choice in treatment options, and providing support tools can enhance retention and treatment completion rates.

Read at Psychology Today