Feb. 24, 2000 (Minneapolis) -- A long-term follow-up study of patients
diagnosed with anorexia nervosa found that half had achieved a full recovery.
That's the good news. The bad news is that the rest of the patients did not
fully recover, and some died of the disease. The report was published in the
Feb. 26 issue of the medical journal The Lancet.
Little is known about the long-term recovery of persons with anorexia, but
researchers at the University of Heidelberg Medical Hospital in Germany
recently completed a follow-up study of 77 females who had been diagnosed and
treated 21 years earlier. Their results shed new light on the long-term
prognosis for people with the disease.
Research suggests that about 1% of female adolescents have anorexia nervosa,
an illness described by some doctors as "the relentless pursuit of
thinness." Although the condition primarily affects women in their teens
and twenties, doctors have reported disorders in children as young as 6 and
adults as old as 76. Only about 5-10% of people with anorexia are male.
The women in the study completed psychiatric interviews, physical
assessments, and psychological questionnaires, and then were classified as
having a good, intermediate, or poor outcome based on standard guidelines for
Among the study patients, 51% had a full recovery and 26% were classified as
having a "poor outcome." Of these, 10% still met full criteria for
anorexia nervosa and 16% died of causes associated with the disease, including
infection, dehydration, and suicide.
Researchers also found significant differences in psychosocial factors
between the outcome groups. For instance, patients classified as poor outcome
missed an average of 99 workdays a year, compared with 40 days for the
intermediate group and three days for the good outcome group.
From their results, the researchers developed theories about what could
predict poor outcomes. The longer a person is ill before receiving treatment is
associated with a poor outcome. Also, inadequate weight gain while hospitalized
for anorexia also pointed to a poor outcome. Those who did worse in the long
run also had severe psychological and social problems.
"We knew that [anorexia] is very serious and is associated with high
mortality [death rate]," researcher Stephan Zipfel, MD, tells WebMD. But
the main message from their research, he says, is that earlier intervention and
referral to specialized facilities are crucial to ensure better patient
According to Anorexia Nervosa and Related Eating Disorders Inc. (ANRED),
without treatment, up to 20% of people with serious eating disorders die. But
with treatment, that number falls to 2-3%. In addition, they say, with
treatment about 60% of people with eating disorders recover.
Persons with anorexia nervosa may display many warning signs including
refusal to maintain a normal body weight, weighing 85% or less than is expected
for age and height, denying the dangers of low weight, and reporting feeling
fat even when very thin.