Signs of Recovery from Eating Disorders

Anorexia and bulimia study sheds light on best treatment options for patients

Eating disorders are illnesses that affect both adults and youth. In a recent study, researchers pinpointed a number of factors that predict long-term recovery from eating disorders.

The researchers considered three different signs of recovery at the end of treatment. These included maintaining an ideal weight, a positive change in psychology and refraining from behavioral patterns linked to eating disorders.

Of these three factors, the researchers found that patients who maintained an ideal weight at the end of treatment had the greatest likelihood of long-term recovery.

Further research found that bulimic patients who did not vomit after consuming meals more than twice a month were more likely to have long-term recovery. Patients with binge eating disorders who had a positive change in psychology, as noted by decreased levels of anxiety and depression, were less likely to relapse after treatment as well.

"Talk to a doctor if you're concerned about weight gain."

James Lock, MD, PhD, Professor of Psychiatry and Behavioral Sciences at the Lucile Salter Packard Children's Hospital at Stanford, and colleagues aimed to determine which signs of recovery at the end of treatment were more likely to signify lasting recovery for patients upon further check-ups.

This study was conducted using five randomized clinical trials on patients with anorexia nervosa, bulimia nervosa and binge eating disorder. The patients consisted of both youth and adults.

The study included approximately 83 adolescents and 28 adults with anorexia nervosa, 49 adolescents and 101 adults with bulimia nervosa, and 97 adults with binge eating disorder. Patients with binge eating disorders consisted of adults only.

For two years, the researchers followed patients who had undergone treatment and follow-up appointments. Signs of recovery at the end of treatment included maintaining an ideal weight, a change in psychology or a change in behavior. Patients were assigned a particular ideal body weight to maintain.

Anorexia nervosa is a condition in which a person goes to abnormal extremes to avoid weight gain, such as starvation or excessive exercise. Bulimia nervosa is a condition in which a person regularly forces oneself to vomit after eating an excessive amount of food in order to avoid weight gain.

Binge eating disorder consists of eating a large amount of food in a short amount of time. Purging is forcing oneself to vomit shortly after consuming a large amount of food.

The researchers found that adolescents with anorexia who achieved 95.2 percent of their ideal weight at the end of treatment were significantly more likely to have long-term recovery.

For this study, the research showed that adults with anorexia who achieved weight gain greater than 85.8 percent of their ideal weight were more likely to experience long-term recovery than patients who did not.

Furthermore, the researchers found that the best sign of long-term recovery in adolescents with bulimia was engaging in binging and purging less than two times a month. About 72 percent of the patients who met this standard at the end of treatment were considered recovered upon further appointments.

For adults with bulimia, the researchers found the best sign of long-term recovery was engaging in bulimic behavior less than two times a month at the end of treatment as well.

For patients with binge eating disorders, a positive psychology, such as being less anxious or depressed, was the best sign of long-term recovery. What is perhaps most noteworthy is that patients with binge eating disorders with a positive state of mind were more likely to recover than those who consumed large amounts of food less often at the end of treatment.

While this study may shed light on which factors contribute to a greater likelihood for a successful recovery, further research is needed.

“Nonetheless, the relationship between end of treatment response and recovery remains understudied; however, both clinicians and patients share an interest in having treatment outcome predict future recovery," Dr. Lock and colleagues wrote.

"Hence, it is important to understand the probability that a patient's clinical status at the end of treatment leads to longer-term recovery," they wrote.

From a clinical perspective, evaluating the markers of success that contributed to long-term recovery at the end of treatment in past patients may help future patients determine which course of action is best for them.

This study was published August 24 in the International Journal of Eating Disorders. The study was funded by the Department of Behavioral Sciences of Stanford University School of Medicine. The authors declared no conflicts of interest.

Review Date: 
August 20, 2013