Women With Anorexia Nervosa Often Relapse

Even After Treatment, Risk of Repeat Episode High for People With the Eating Disorder

June 25, 2004 -- The road to recovery may be a long one for women with anorexia nervosa. A new study shows about one in three women treated for the eating disorder experience a relapse within two years after being discharged from the hospital.

Anorexia nervosa affects less than 1% of the population -- about 90% are teen girls or young women. People with anorexia have such a fear of gaining weight that they severely limit how much they eat, leading to serious health problems from malnourishment or even death.

Although effective treatments have been developed, researchers say many people with anorexia experience relapse. At this point, they say it's not clear whether problems in the initial treatment or inadequate relapse prevention strategies are to blame for the high relapse rates.

Anorexia Nervosa May Be Chronic Disease for Some

In the study, researchers followed 51 women who had regained weight after treatment for anorexia nervosa for the first time at an inpatient hospital program. The results appear in the May issue of Psychological Medicine.

The study showed that within two years of hospital discharge, 35% of the women had relapsed into anorexia, as defined by a drop in body mass index (BMI, a measure of weight in relation to height) below 17.5 for three consecutive months or more. This would be equivalent to a 5-foot-5-inch woman weighing less than 105 pounds.

Researchers found the highest risk period was from six to 17 months after discharge, which contrasts with previous studies that show that those who relapsed would do so within a year after treatment.

"Our most important finding is that in a significant proportion of cases, the illness is chronic and debilitating," says researcher Jacqueline Carter, a psychiatry professor at the University of Toronto, in a news release. "We're pretty good at helping people to become weight-restored in the hospital, but really the challenge now is to figure out how to improve relapse prevention treatments and improve long-term outcomes for people with anorexia nervosa."

The study showed several factors were related to a higher likelihood of relapse, including:

  • Excessive exercise immediately after discharge
  • A history of suicide attempt
  • Previous treatment for an eating disorder
  • Obsessive-compulsive symptoms at time of initial treatment
  • Excessive concern about body shape and weight at time of discharge

Researchers say knowledge of these risk factors should be used to develop treatments to prevent for anorexia relapse.

Show Sources

SOURCES: Carter, J. Psychological Medicine, May 2004; vol 34: pp 671-679. News release, University of Toronto.

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