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

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

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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  1. [5]Robinson P. Severe and Enduring Eating Disorder (SEED): Management of Complex Presentations of Anorexia and Bulimia Nervosa. Chichester, UK: John Wiley & Sons; 2009.
  2. [20]Muthén LK, Muthén BO. Mplus User’s Guide. Seventh Edition. Los Angeles, CA, Muthén & Muthén; 1998– 2012.
  3. [21]Enders CK. Applied Missing Data Analysis. New York, NY: Guilford Press; 2010.

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Metadata

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
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
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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