Ten percent of patients assessed at Toronto General Hospital Eating Disorder
Centre require admission to hospital. In a comparative study of 100 consecutive admissions, differences in weight, eating disorder symptoms, and psychopathology between inpatients and outpatients were most apparent in the group with bulimia nervosa. Patients admitted with anorexia nervosa and with bulimia nervosa also had a longer duration of illness compared to outpatients. At discharge the anorexic patients weighed approximately 85% of ideal body weight. After a mean follow-up period of 2 years, 50% of patients were in the "good" outcome category, whereas 16% were rated as having a "poor" outcome. Patient attitudes to various components of the program did not appear to influence outcome.
Until very recently most patients with anorexia nervosa were treated in hospital. However, with the increasing frequency of eating disorders, bed shortages, and sophistication of outpatient management, more patients are being treated entirely as outpatients. In our setting only 10% of individuals with an eating disorder referred for consultations become inpatients. Although specific indications for admission have been described (Garfinkel & Gamer, 1982), there have been no studies to date which have assessed the psychological characteristics of those patients who require inpatient care relative to the anorexic and