Early response is a well-established predictor of positive outcomes at the end of psychological treatments for common mental disorders. There is some prior evidence that this conclusion also applies to eating disorders, including three meta-analyses, but no moderators of that relationship have been identified. However, a number of further papers have been published since, which might influence the size of the effect of early response or the potential role of moderating factors. This pre-registered systematic review presents a comprehensive examination of this literature. Three databases were searched (Scopus, PsycInfo, PubMed). In total, 33 eligible studies were included in a narrative synthesis, and 25 studies were included in random-effects meta-analysis. The majority (91%) of studies were rated as having low or moderate risk of bias. Approximately half of patients across clinical samples showed early response to psychological therapy, which was most often defined as reliable symptomatic improvement during the first four sessions. A significant and moderate association was found between early response and post-treatment outcomes (r = 0.41 [95% CI: 0.32–0.481], p < .0001). Significant evidence of heterogeneity (Q[28] = 136.42, p < .0001; I² = 80.2%) was evident. The review was limited by the exclusion of grey literature and only 76% of studies provided sufficient statistical information for meta-analytic synthesis, although we found no significant evidence of publication bias, χ²(1) = 0.001, p = .97. Overall, evidence accumulated over twenty years establishes early response as the most robust predictor of treatment outcomes in the field of eating disorders. However, only half of patients show early change in this way. Further research is needed to determine whether there are patient or clinician characteristics that predict early response to psychological treatment for eating disorders.

早期反应是常见精神障碍心理治疗结束时积极结果的公认预测指标。有一些先前的证据表明这一结论也适用于饮食失调，包括三项荟萃分析，但尚未确定这种关系的调节因素。但是，此后又发表了许多论文，这可能会影响早期反应的影响大小或调节因素的潜在作用。这篇预先注册的系统综述对这些文献进行了全面的检查。搜索了三个数据库（Scopus、PsycInfo、PubMed）。总共有 33 项符合条件的研究被纳入叙述性综合，25 项研究被纳入随机效应荟萃分析。大多数 (91%) 研究被评为具有低或中等偏倚风险。临床样本中大约一半的患者对心理治疗表现出早期反应，这通常被定义为前四次治疗期间可靠的症状改善。在早期反应和治疗后结果之间发现了显着和中等的关联（r  = 0.41 [95% CI：0.32–0.481]，p  < .0001）。异质性的显着证据（Q[28] = 136.42，p  < .0001；I ²  = 80.2%）很明显。该评价因排除灰色文献而受到限制，只有 76% 的研究为荟萃分析合成提供了足够的统计信息，尽管我们没有发现发表偏倚的显着证据，χ ² (1) = 0.001, p = .97。总体而言，二十多年来积累的证据表明早期反应是饮食失调领域治疗结果的最有力预测指标。然而，只有一半的患者以这种方式表现出早期变化。需要进一步的研究来确定是否有患者或临床医生的特征可以预测对饮食失调心理治疗的早期反应。