Who Recovers from Anorexia Nervosa?

Anorexia nervosa is marked by purposeful underweight due to intense fears of becoming fat and serious distortions about weight and shape. Anorexia nervosa is a potentially life-threatening and chronic disorder. Therefore, it is important to know what factors impede or aid in recovery. Enabled by a nationalized health system, Anna Keski-Rahkonen and her Finnish colleagues examined a cohort of twins born between 1975 and 1979 to determine the prevalence of anorexia and whether those diagnosed subsequently recovered. Recovery was defined as restoration of weight and menstruation and the cessation of bingeing or purging for at least a period of a year prior to assessment. The researchers also looked at the factors associated with recovery.

Overall, out of 2,8881 women, 55 cases of Anorexia Nervosa were detected. Women were more likely to recover (39 women) than not (16 women). Those who were not recovered were more likely to be perfectionistic and suffer from some adverse outcomes, such as unemployment and poor relationship satisfaction, but not others, such as university education and income. The largest factor associated with lack of recovery after controlling for how long a person had anorexia was depression that had emerged before the eating disorder diagnosis.

Finland is a western, developed nation that, unlike the U.S., has a homogenous population. Therefore, generalizability to the U.S. may be curtailed by this fact. Still, there may be important implications derived from this large population study. Depression co-morbid to anorexia nervosa deserves specialized attention in treatment. Further, depression should be identified early and treated so that it does not lead to the development of other disorders, such as anorexia, and their becoming entrenched.

Keski-rahkonen, Anna ; Raevuori, Anu ; Bulik, Cynthia M ; Hoek, Hans W ; Rissanen, Aila ; Kaprio, Jaakko. (2014). Factors associated with recovery from anorexia nervosa: A population-based study. The International Journal of Eating Disorders, 47, 117-23

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