Journal of the American Academy of Child & Adolescent Psychiatry
Volume 38, Issue 7 , Pages 829-837, July 1999

Recovery and Relapse in Anorexia and Bulimia Nervosa: A 7.5-Year Follow-up Study

Dr. Herzog is Professor of Psychiatry (Pediatrics), Harvard Medical School, President and Founder of the Harvard Eating Disorders Center, and Director of the Eating Disorders Unit, Massachusetts General Hospital, Boston Dr. Dorer is biostatistical consultant. Dr. Keel is Assistant Professor of Psychology, Harvard University, Cambridge, MA. Ms. Selwyn, Ms. Ekeblad, Ms. Flores, Ms. Greenwood, and Ms. Burwell are research assistants at the Eating Disorders Unit, Massachusetts General Hospital. Dr. Keller is Professor and Chairman, Department of Psychiatry and Human Behavior, Brown University, Providence, RI

Accepted 8 February 1999.

ABSTRACT 

Objective

To assess the course and outcome of anorexia nervosa (AN) and bulimia nervosa (BN) at a median of 90 months of follow-up in a large cohort of women with eating disorders.

Method

A prospective, naturalistic, longitudinal design was used to map the course of AN and BN in 246 women. Follow-up data are represented in terms of full and partial recovery, predictors of time to recovery, and rates and predictors of relapse.

Results

The full recovery rate of women with BN was significantly higher than that of women with AN, with 74% of those with BN and 33% of those with AN achieving full recovery by a median of 90 months of follow-up. Intake diagnosis of AN was the strongest predictor of worse outcome. No predictors of recovery emerged among bulimic subjects. Eighty-three percent of women with AN and 99% of those with BN achieved partial recovery. Approximately one third of both women with AN and women with BN relapse after full recovery. No predictors of relapse emerged.

Conclusions

The findings suggest that the course of AN is characterized by high rates of partial recovery and low rates of full recovery, while the course of BN is characterized by higher rates of both partial and full recovery.

Key Words:  recovery , relapse , anorexia , bulimia

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 This study was sponsored in part by grants from the NIMH (5R01 MH 38333 05), the Rubenstein Foundation, and the Harvard Eating Disorders Center. The authors thank Ana Richards and Karin Nussbaum for their assistance.

PII: S0890-8567(09)66531-X

doi:10.1097/00004583-199907000-00012

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 38, Issue 7 , Pages 829-837, July 1999

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