Q. We frequently read about the poor outcome of patients with anorexia nervosa (AN). Is there any hopeful news? (JK, Gallup, NM)

A. In a recent report from England (Int J Eat Disord 2014; 47:507), the standardized mortality rate (SMR) for anorexia nervosa (AN) in people aged 15-24 years was 11.5; in contrast, the rate for bulimia nervosa (BN) was 4.1, and eating disorders not otherwise specified (EDNOS) was 1.4. Specifically, the crude mortality rate for AN was 14%.

In one of the few studies that have assessed the long-term health-related outcome of AN patients in the general population, none of 55 Finnish women with DSM-IV AN had diagnosed AN, followed from the population based Finn Twin 16 Cohort, none of the women with AN had died and 88% were weight-recovered. This study was reported at the International Eating Disorders Conference in New York this spring. The women with lifetime histories of AN were at least equally likely to have a university degree (38% vs. 29%) as the general population and to be employed.

The researchers concluded that the long-term prognosis of patients with AN living in the community was favorable in several ways: successful weight restoration was very common and economic dependence on society was rare. Dr. Linda Mustelin and colleagues from the University of Helsinki did, however, report that AN did take a physical and psychological toll on the women: those who recovered from AN had a lower likelihood of having children and of living with a partner. The women also had higher-than-normal psychological distress, particularly those who had been in treatment less than 10 years. The researchers found that the women with AN more often showed continuing psychological distress, as measured by the General Health Questionnaire than did women from the general population: 33% vs. 18%, respectively.

— SC