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Trial registered on ANZCTR
Registration number
ACTRN12616000816459
Ethics application status
Approved
Date submitted
16/06/2016
Date registered
21/06/2016
Date last updated
22/01/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Weighing Practices in the early stages of inpatient treatment for Anorexia and Bulimia Nervosa
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Scientific title
Anxiety levels, weight gain and weight preoccupation following open vs blind weighing in the early stages of inpatient treatment for Anorexia Nervosa and Bulimia Nervosa
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Secondary ID [1]
289332
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anorexia Nervosa
298939
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Bulimia Nervosa
306293
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Condition category
Condition code
Mental Health
299017
299017
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0
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Eating disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
"Open weighing”: Patients are individually weighed in their underwear by a nurse twice weekly for four weeks. Weighing takes place in the morning in front of the nurses station before patients have breakfast. The outcome is communicated clearly to the patient in form of an actual weight (not simply "up", "down", or "OK"). The patient's weight is then overtly discussed between the patient and treating team (e.g., dieticians, psychologists, psychiatrists) and this information is used as a part of treatment. For example, dieticians may make changes to the patient's meal plan depending on weight gain/loss and psychologist may discuss weight in the context of cognitive behavioural therapy sessions. Patients are asked to complete outcome measure questionnaires directly before and after being weighed.
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Intervention code [1]
294892
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Treatment: Other
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Comparator / control treatment
“Blind weighing”: Patients are individually weighed in their underwear by a nurse twice weekly for four weeks. Weighing takes place in the morning in front of the nurses station before patients have breakfast. The patient's weight information is shared with the treating team (e.g., dieticians, psychologists, psychiatrists) but not with the patient. Specific weight information (i.e., the exact number on the scale) is not used as a part of treatment. To justify treatment decisions (e.g., changes in meal plan) the treating team may communicate to the patient whether the weight has gone up or down but will not discuss actual numbers. Patients are asked to complete outcome measure questionnaires directly before and after being weighed.
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Control group
Active
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Outcomes
Primary outcome [1]
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Mean anxiety reactions to being weighed as assessed by 100mm Visual Analogue Scales (4 questions; e.g., How anxious are you about being weighed right now?)
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Assessment method [1]
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Timepoint [1]
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At baseline session immediately before and after being weighed; and then twice weekly on weighing days for 4 weeks. .
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Secondary outcome [1]
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Rate of weight gain. Participants are weighed by registered nurses using calibrated digital scales
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Assessment method [1]
324765
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Timepoint [1]
324765
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Baseline and then twice weekly for 4 weeks
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Secondary outcome [2]
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Mean body and weight preoccupations as assessed by the Eating Disorder-15
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Assessment method [2]
324766
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Timepoint [2]
324766
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Baseline and then weekly for 4 weeks
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Secondary outcome [3]
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Mean tolerance of uncertainty scores as assessed by the Intolerance of Uncertainty scale
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Assessment method [3]
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Timepoint [3]
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At baseline and at completion of the intervention (at 4 weeks)
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Secondary outcome [4]
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Meal completion. Patients who refuse or cannot complete a meal or snack are required to drink a liquid meal supplement (e.g., Ensure) of equal caloric content. The quantity of liquid meal supplement required (this is always equivalent to the amount of food left on the plate) is recorded by nurses and will be used to assess meal non compliance.
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Assessment method [4]
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Timepoint [4]
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Meal completion (or non compliance) is recorded in the patient's chart after each meal/snack. This data will be used to track meal completion across 4 weeks from intervention commencement.
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Secondary outcome [5]
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Treatment motivation as assessed by 100mm Visual Analogue Scales (3 questions; e.g., How motivated do you feel right now to engage with your treatment?)
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Assessment method [5]
324769
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Timepoint [5]
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At baseline and then on a weekly basis.
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Eligibility
Key inclusion criteria
Females, 16 years and over. Newly admitted patients to Wesley Hospital Ashfield, diagnosed with Anorexia Nervosa and/or Bulimia Nervosa.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Age (<16), gender (male)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomisation. Each new block will be randomised through a blind random binary list created by an external statistician.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
Participants will be randomised to either open weighing or blind weighing. To prevent potential problems of drop-out that may result if participants from different groups are treated alongside one another in hospital and become dissatisfied with their allocation, we will divide the sample into blocks and randomly assign these blocks to one of the two conditions. Once all participants from a block have discharged, recruitment for the next block will start.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
For a between group difference in mean scores on the visual analogue ratings of anxiety, a medium to large (clinically relevant) effect size of 0.6 would at power of 80%, thus beta of 0.20, and significance (p) of 5% (0.05) for 1-sided test a group size of n=36 would be required and thus allowing for some attrition (6/42 per group or approximately 15%) a total sample size of n=84 is needed.
The data of this study will be analysed using mixed-effects models (MEM). We hope to determine which approach is more beneficial for patients in the early stages of therapy.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
29/08/2016
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Actual
29/03/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
84
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Accrual to date
5
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Wesley Hospital Ashfield - Ashfield
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Recruitment hospital [2]
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Northside West Clinic - Wentworthville
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Recruitment postcode(s) [1]
13391
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2131 - Ashfield
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Recruitment postcode(s) [2]
18622
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2145 - Wentworthville
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Recruitment outside Australia
Country [1]
7953
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United Kingdom
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State/province [1]
7953
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West Midlands
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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UNSW Australia
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Address [1]
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UNSW Australia
Sydney NSW 2052
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Country [1]
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Australia
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Primary sponsor type
University
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Name
UNSW Australia
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Address
UNSW Australia
Sydney NSW 2052
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Wesley Hospital Ashfield
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Address [1]
292679
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91 Milton Street Ashfield NSW 2131
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Country [1]
292679
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295240
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UNSW Human Research Ethics
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Ethics committee address [1]
295240
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UNSW Australia, Sydney NSW 2052
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Ethics committee country [1]
295240
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Australia
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Date submitted for ethics approval [1]
295240
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30/06/2016
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Approval date [1]
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10/08/2016
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Ethics approval number [1]
295240
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HC 16539
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Summary
Brief summary
This study aims to compare different weighing practices in the early stages of inpatient treatment for Anorexia Nervosa and Bulimia Nervosa. Specifically, we aim to compare the benefits of “open weighing” (where patients are weighed within the therapy session and their weight is then discussed with the therapist overtly) and “blind weighing” (where patients are weighed by the therapist but this information is not shared with him or her). Despite considerable debate about this issue in the literature, to our knowledge, there has been no systematic comparison of patient outcomes following blind and open weighing. Weighing is a key component in the treatment of eating disorders and specific evidence is needed to determine which approach is most beneficial for patients. The current project aims to fill this gap by comparing weighing methods in a specialised inpatient setting. Participants will be randomised to either open weighing or blind weighing. Following consent (assent for adolescents aged< 18 years), participants will be randomised in blocks. The primary outcome variable will be anxiety levels before and after being weighed. Secondary outcomes include rate of weight gain, body and weight preoccupations, tolerance of uncertainty, meal completion and treatment motivation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ms Franzisca Froreich
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Address
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UNSW Australia, Sydney NSW 2052
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Country
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Australia
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Phone
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+61 449 559 470
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Fax
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Email
66282
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[email protected]
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Contact person for public queries
Name
66283
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Franzisca Froreich
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Address
66283
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UNSW Australia, Sydney NSW 2052
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Country
66283
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Australia
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Phone
66283
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+61 449 559 470
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Fax
66283
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Email
66283
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[email protected]
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Contact person for scientific queries
Name
66284
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Franzisca Froreich
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Address
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UNSW Australia, Sydney NSW 2052
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Country
66284
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Australia
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Phone
66284
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+61 449 559 470
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Fax
66284
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Email
66284
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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