An eight-year follow-up: Outcome from adolescent compared to adult onset anorexia nervosa

Seventy-five women were traced and reassessed on average eight years after the onset of anorexia nervosa. All patients received treatment and 88% were hospitalized at least once. Comparisons between early (11-15 years; N = 35), late (16-18 years; N = 24) adolescent and adult (19-27 years; N = 14) onset revealed no significant differences in outcome for age at onset. For 70% of adolescent and 42% of adult onset patients the outcome was good, meaning that the weight was within +/- 15% of norm with regular cyclical menstruation, 17% and 21% had an intermediate, and 9% and 21%, respectively, had a poor outcome 5.3% had died. Taken together 59% had physically recovered and were free of an eating disorder Severity of illness reflected in a low body mass index, excessive exercise and poor psychosocial functioning at intake were poor prognostic indicators; length of illness and food restriction or bulimia as earing patterns were unrelated to outcome. The observation that all women with chronic anorexia nervosa, and even a third of those who had physically recovered from anorexia nervosa, qualified for one or more psychiatric diagnoses suggests that the psychosocial correlates of anorexia nervosa require further study.