Therapeutic Outcome in Anorexia Nervosa

Abstract

There are no controlled studies of the outcome of treatment for anorexia nervosa. An early study showed that biologically recovered anorectics were, as a group, socially phobic four years following the completion of treatment. This position is more sophisticated and mature than that at the time of their original anorexia and one shared by many "normal" people. A recent study evaluated treatment in terms of strict criteria for good outcome: all the patients had been severely ill with anorexia nervosa when first seen. Four to seven years later, 84% were holding a body weight above the pubertal threshold but of these, 2% were obese and 18% were well below average adult weight. Sixty-four percent, therefore, were sustaining a normal and stable body weight and the majority of these had regular menses. Quite a number were preoccupied with body shape, but their psychosocial adjustment was reasonable. In contrast, 14% had remained severely ill and only 2% had died. These findings suggest that treatment aims at altering the long term cause of the disorder for the better is probably effective in (a) helping about 20 to 30% of the population to recover who would not otherwise have done so; and (b) in preventing some deaths.

Readiness for change and short‐term outcomes of female adolescents in residential treatment for anorexia nervosa

“…The total score is utilized to determine the overall level and stage of RFC (Pre-Contemplation, Contemplation, Preparation, Action, or Maintenance). The total score ranges from 20-100 and the individual stage of change score ranges are: Pre-contemplation (20)(21)(22)(23)(24)(25)(26)(27)(28)(29), Contemplation (30-49), Preparation (50-69), Action (70-89), and Maintenance (90-100). The instrument has demonstrated good internal consistency (0.90) and test-retest reliability (0.89).…”

“…26 One body of research on outcomes of AN has largely focused on a restricted view of AN recovery outcomes composed only of weight gain and resumption of menses. [27][28][29] Others have focused on the resolution of core AN symptoms such as fear of becoming fat, drive for thinness, body image disturbance, or presence of the diagnosis. [30][31][32][33][34] A number of researchers have suggested that a more multidimensional biopsychosocial view of recovery be examined to fully understand the overall effectiveness of treatment and the impact of disease on the patient's life.…”

The outcome of anorexia nervosa: a reappraisal

“…Two-thirds (11/17, or 12% overall) of the deaths in the Swedish study occurred within the first seven years of onset of illness. The mortality rate within a similar time period after onset of illness in the recent studies (see above) are lower (0-5 %), and perhaps attributable to better treatment (Crisp, 1981). However, none of the studies were designed to test treatment effects.…”

Differential Responses of Circulating Prolactin, GH, and ACTH Levels and Distribution and Activity of Submaxillary Lymph Node Lymphocytes to Calorie Restriction in Male Lewis and Wistar Rats

“…The other groups of rats (n = 14 for each strain) were housed individually, 7 of them with free access to food (AIN-93G) and water and the other 7 with free access to 7 g of an equilibrated diet (AIN-93G, enriched in proteins and low in fat and carbohydrates; equivalent to a 66% food restriction) and water for 4 weeks. Calorie restriction was calculated considering the average of food consumption of the control group, following an anorexic pattern [26][27][28]. All experiments were conducted in accordance with the guidelines of the International Council for Laboratory Animal Science.…”