Cited by 535Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

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Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up

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Eddy, Kamryn T., Tabri, Nassim, Thomas, Jennifer J., Murray, Helen B., Keshaviah, Aparna, Hastings, Elizabeth, Edkins, Katherine, Krishna, Meera, Herzog, David B., Keel, Pamela K., Franko, Debra L.·2017·The Journal of Clinical Psychiatry

DOI 10.4088/jcp.15m10393PMC PMC7883487

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Abstract

OBJECTIVE: The course of eating disorders is often protracted, with fewer than half of adults achieving recovery from anorexia nervosa or bulimia nervosa. Some argue for palliative management when duration exceeds a decade, yet outcomes beyond 20 years are rarely described. This study investigates early and long-term recovery in the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa. METHODS: Females with DSM-III-R/DSM-IV anorexia nervosa or bulimia nervosa were assessed at 9 and at 20 to 25 years of follow-up (mean [SD] = 22.10 [1.10] years; study initiated in 1987, last follow-up conducted in 2013) via structured clinical interview (Longitudinal Interval Follow-Up Evaluation of Eating Disorders [LIFE-EAT-II]). Seventy-seven percent of the original cohort was re-interviewed, and multiple imputation was used to include all surviving participants from the original cohort (N = 228). Kaplan-Meier curves estimated recovery by 9-year follow-up, and McNemar test examined concordance between recovery at 9-year and 22-year follow-up. RESULTS: At 22-year follow-up, 62.8% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa recovered, compared to 31.4% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa by 9-year follow-up. Approximately half of those with anorexia nervosa who had not recovered by 9 years progressed to recovery at 22 years. Early recovery was associated with increased likelihood of long-term recovery in anorexia nervosa (odds ratio [OR] = 10.5; 95% CI, 3.77-29.28; McNemar χ²₁ = 31.39; P < .01) but not in bulimia nervosa (OR = 1.0; 95% CI, 0.49-2.05; McNemar χ²₁ = 0; P = 1.0). CONCLUSION: At 22 years, approximately two-thirds of females with anorexia nervosa and bulimia nervosa were recovered. Recovery from bulimia nervosa happened earlier, but recovery from anorexia nervosa continued over the long term, arguing against the implementation of palliative care for most individuals with eating disorders.

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“Around 20 percent of individuals who experience anorexia nervosa (AN) have a protracted illness course [3, 4].”
Background
What kind of illness is anorexia nervosa? Revisited: some preliminary thoughts to finding a cure
Touyz, S. W., Bryant, E., Dann, K. M., Polivy, J., Grange, D. L., Hay, P., Lacey, H., Aouad, P., Barakat, S., Miskovic‐Wheatley, J., et al. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00944-3 · Cited by 27

Authors: Eddy, K. T., Tabri, N., Thomas, J. J., Murray, H. B., Keshaviah, A., Hastings, E., Edkins, K., Krishna, M., Herzog, D. B., Keel, P. K., & Franko, D. L.
Affiliations: Harvard University (US)
Massachusetts General Hospital (US)
Florida State University (US)
Northeastern University (US)
Corresponding author: Eddy, Kamryn T.
ORCID: Eddy, Kamryn T.
Tabri, Nassim
Thomas, Jennifer J.
Murray, Helen B.
Keshaviah, Aparna
Keel, Pamela K.
Franko, Debra L.
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2016-12-20
Volume: 78
Issue: 02
Pages: 184-189
ISSN: 0160-6689 (ISSN-L)
DOI: 10.4088/jcp.15m10393
PMC: PMC7883487
OpenAlex: W2564469912
Cited by: 535
References: 31
Citations by year: 2026: 43 · 2025: 59 · 2024: 86 · 2023: 77 · 2022: 62 · 2021: 75 · 2020: 67 · 2019: 28 · 2018: 21 · 2017: 13
FWCI: 27.63
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: The Journal of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R03MH094832, R01MH038333)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: anorexia nervosa, bulimia nervosa, eating disorders, long-term recovery, recovery trajectories, early recovery, longitudinal follow-up, women, palliative care, relapse and remission, multiple imputation
MeSH terms: Adult, Anorexia Nervosa, Female, Follow-Up Studies, Humans, Interview, Psychological, Longitudinal Studies, Middle Aged, Prognosis, Bulimia Nervosa, Young Adult

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Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up

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