HealthDay News — Anorexia nervosa (AN) has long-term negative consequences, and many patients do not experience remission, according to a study published online in the International Journal of Eating Disorders.

Manfred Maximilian Fichter, MD, from Ludwig Maximilians University in Munich, and colleagues examined the long-term outcomes of AN in 1,693 inpatients admitted over 25 years. They defined a subsample of 112 patients with 20-year follow-up.

The researchers observed an increase in body mass index (BMI) during follow-up. There were improvements in eating behavior and general psychopathology, but the levels did not reach those of healthy controls. Thirty percent of the total sample and 40% of the 20-year follow-up subsample experienced remission. 

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Cases of cross-over to binge-eating disorder or obesity were rare; the main diagnostic crossover was from AN to eating disorder not otherwise specified.Lower BMI at admission, higher score on the Eating Disorder Inventory Maturity Fears subscale at admission, fewer follow-up years, and higher age at admission were predictors of a negative course of illness. Motherhood correlated with improved outcomes.

“Many patients with very severe AN recover from their illness but AN also shows considerable long-term negative consequences,” the authors write. “Over long time periods, survivors show improvement but better treatments for severe cases are still needed. Predictors of outcome included symptom severity, chronicity, and length of follow-up but not psychiatric comorbidity.”

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Fichter MM, Quadflieg N, Crosby RD, Koch S. Long-term outcome of anorexia nervosa: Results from a large clinical longitudinal study. [published online June 23 2017]. Int J Eat Disord.  doi: 10.1002/eat.22736. 

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