Anorexia Nervosa – More Common And Transient Than Previously Thought

In the first nationwide outcome study anorexia of conducted to date, anorexia is a common, often severe, but highly transient illness. Its outcome is generally good: up to 70% of women with anorexia recover before age 30 according to collaborating scientist at Columbia University and University of Helsinki, Finland.

Anorexia is common but often overlooked

In the Finnish study, 2.2% of Finnish young women suffered from severe anorexia nervosa. When milder forms of self-starvation and obsessive anxiety about weight and shape were included, up to 5% of women suffered from anorexic symptoms during their lifetime. Anorexic symptoms usually started between ages 10 and 25; the peak of illness onset was between ages 15 and 19. Although Finland has an excellent taxpayer-funded healthcare system that covers everyone, only half of women with anorexia nervosa were recognized by healthcare professionals. Even fewer received any type of treatment for their symptoms.

Seven out of ten women with anorexia recover

By age 30, up to 70% of women with anorexia had recovered from their illness. On average, the duration of anorexia was three years; about 25% recovered within a year, about 33% within 2 years, and about 67% within 5 years from the onset of their symptoms.

Recovery from anorexia was usually slow and gradual. First, lost weight was regained and menstruation resumed. Attitudes about body shape and weight took a much longer time to resolve. The Finnish study was conducted among pairs of female twins. Twins with anorexia nervosa were compared to their healthy co-twins and to healthy women from the general population. Within five years from weight restoration, women with anorexia nervosa were virtually indistinguishable from their healthy co-twins in terms of psychological symptoms and self-esteem. However, learning to deal with body shape and weight related concerns took usually much longer, 5-10 years.

“Will I be able to marry, have children, work, and have a normal life?”
Women in the acute starvation phase of anorexia were less likely to date, live in long-term relationships, and marry than their healthy co-twins and other healthy women. However, women who had recovered from anorexia nervosa were just as likely to date, have sexual relationships, marry, and have children than healthy women. Women recovering from anorexia were also as likely to continue their studies and to find steady employment than healthy women.

The study was conducted as a collaboration of the the Departments of Psychiatry and Public Health, University of Helsinki, Finland, and Mailman School of Public Health at Columbia University. The study comprised almost 3000 participants: virtually all female twins born in Finland in 1975-79.

The study is reported in detail in American Journal of Psychiatry (issue Aug 1st, 2007), available online at http://ajp.psychiatryonline.org/