Most Eating Disorder Patients Eventually Recover

Around two out of three women with anorexia nervosa or bulimia nervosa will eventually recover in their lifetime, according to a new study at Massachusetts General Hospital (MGH).

“These findings challenge the notion that eating disorders are a life sentence,” said Kamryn Eddy, Ph.D., of the Massachusetts General Hospital (MGH) Eating Disorders Clinical and Research Program.

“While the road to recovery is often long and winding, most people will ultimately get better. I’ve had patients say to me, ‘Food and my body are only parts of who I am now; neither defines me anymore,’ or ‘My life became more full, and there just wasn’t room on my plate anymore for the eating disorder’.”

Although some research has suggested that fewer than half of adults with eating disorders will recover, the authors note that few of these studies have analyzed outcomes from as long as 20 years or more. In fact, the new findings show that almost 63 percent of anorexia patients had recovered an average of 22 years later, while patients with bulimia tended to recover more quickly.

Participants entered this observational study at MGH between 1987 and 1991, and those in this study’s analysis were followed for 20 years or more. Of the original 246 participants, 136 met criteria for anorexia and 110 for bulimia at the beginning of the study. During the first decade, participants were interviewed every six to 12 months. Then participants were contacted for a follow-up between 20 and 25 years after study outset.

At the end of the first decade, 31.4 percent of those with anorexia had recovered, while 68.2 percent of those with bulimia had recovered. The final evaluation, which included 176 participants and was an average of 22 years later, found that 62.8 percent of those with anorexia and 68.2 percent of those with bulimia had recovered. In both groups, some of those determined to have recovered at the first evaluation had relapsed by the second, but more of those not recovered at the first evaluation had recovered by the final evaluation.

“We set the bar for recovery as being a year without symptoms, and we found that most of those who do recover will stay recovered over time,” said Eddy, also an associate professor of psychology in the Harvard Medical School Department of Psychiatry.

“Still a small subset of patients in both groups did relapse, and we need to work harder to identify predictors of relapse to promote enduring recovery.”

With an overall goal of determining how the brain, hormones and behavioral mechanisms are involved in persistent illness and recovery, the researchers will continue to study the neurobiological basis of eating disorders in recently diagnosed adolescents.

Their findings should shed light on new treatment targets for these prevalent, potentially life-threatening illnesses.

The study is published online in the Journal of Clinical Psychiatry.

Source: Massachusetts General Hospital