Therapeutic outcome in anorexia nervosa.

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.