A long-term Swedish study of around 50 people who struggled with anorexia nervosa in their teens shows that the majority were healthy 30 years later, though some still dealt with persistent eating disorders.
The study, published in The British Journal of Psychiatry, was conducted by researchers at Sahlgrenska Academy, University of Gothenburg in Sweden.
Anorexia nervosa is an eating disorder characterized by weight loss or the lack of appropriate weight gain in growing children. Many anorexia patients struggle with a distorted body image. In general, patients severely restrict the number of calories and the types of foods they eat. Some also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.
Of children and adolescents in Sweden, approximately 1 percent of girls and 0.1 percent of boys develop anorexia. The primary treatment is psychotherapy, aimed at changing the victims’ eating behaviors and helping them cope with their problematic emotions.
The study was initiated in Gothenburg in 1985. Every child in the eighth grade of compulsory school (born 1970) was screened for anorexia nervosa. As a result, 24 adolescents with the disorder were identified and given the opportunity of inclusion in the study. A further 27 adolescents with anorexia born in the early 1970s, who had attracted the attention of the school health services, were added.
Of the resulting total, 48 were women and 3 men. The study was supplemented with an equal number of matched healthy controls, bringing the total number of subjects to 102.
Thirty years after the study began, the researchers contacted the anorexic participants and the healthy controls again. All but four were included in the follow-up.
“Since the study’s partly population-based and includes only people who developed anorexia in their teens, we thought initially that our study participants should be doing better than people in clinical long-term follow-ups, in which the participants were recruited through the care services,” said researcher Dr. Elisabet Wentz, Professor at Sahlgrenska Academy.
“In our study we see no deaths, which unfortunately occur in clinical studies. But as for full recovery from eating disorders, the outcome is the same as in other long-term studies. In line with other studies, 30 of the 47 respondents in the follow-up part of the study have fully recovered.”
One key purpose of the study was to identify factors tied to greater risk for developing anorexia nervosa. The findings indicate that age is one such factor: teens who were slightly older at onset had a better chance of regaining their health.
Other research has shown that perfectionist personality traits are a risk factor for developing anorexia; but in this study, perfectionism before the onset proved to be a factor that enhanced recovery prospects too.
“Perfectionism has two faces, and seems able to serve both harmful and beneficial purposes when it comes to teenage anorexia. Perhaps the fact is that the perfectionism that drove the disease was transformed during the recovery of health, becoming a driver for not falling ill again,” Wentz said.
Importantly, at the 18-year follow up, only 6 of the 51 participants had eating disorders. Twelve years later, the researchers were astonished to find that the proportion with disorders had risen.
“Our expectation was that 30 years after first falling ill, the proportion with eating disorders would show a continued decline. But instead, we see a small increase,” Wentz said.