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Dropout is common in eating-disorder therapy and leads to poorer outcomes and wasted resources.

Patients leave for many reasons such as demanding treatments, low motivation, weak alliance, or logistics.

Engagement strategies—shorter waitlists, patient choice, support tools—may improve retention.

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.

A recent article by Tracey Wade and Ulrike Schmidt in the International Journal of Eating Disorders proposes an interesting perspective on this issue. Rather than focusing solely on identifying predictors of dropout, the authors suggest using what we know about treatment discontinuation to improve treatments' ability to keep patients engaged.

This shift in perspective is important. 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.

Five categories of treatment discontinuation

Wade and Schmidt describe five main categories of treatment discontinuation. The first is patient-initiated dropout. Patients may decide to stop therapy for several reasons. Treatment may be........

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