Outcome in patients with eating disorders: a 5-year study

Background Eating disorders are disabling, unpredictable, and difficult to treat. We did a prospective 5-year investigation of a representative sample of patients with eating disorders. Our aim was to identify predictors of o utcome and to assess effects of available treatments. Methods We prospectively investigated 95 patients with anorexia nervosa, 88 with bulimia nervosa, and 37 with eating disorders not otherwise specified (EDNOS), who sought treatment in Adelaide, South Australia. We divided pat ients into those who had, and had not, received treatment in specialist uni ts and reached a safe body weight. Individuals were then further classified dependent on intensity of any treatment received. We assessed clinical sym ptoms, body-related attitudes, and psychosocial function. Findings 216 (98%) patients were available for follow-up after 5 years. Thr ee patients with anorexia nervosa and two with EDNOS died. 65 (74%) bulimic , 29 (78%) EDNOS, and 53 (56%) anorexic patients had no diagnosable eating disorder. A small proportion of patients in every group had poor Morgan-Rus sell-Hayward scores at outcome. Final outcome was predicted by extent and i ntensity. but not duration, of initial symptoms in patients with anorexia n ervosa, and by initial body-related attitudes and impaired psychosocial fun ctioning in bulimia patients. We were unable to predict EDNOS outcome. Trea tment did not affect outcome for any group. Interpretation Deaths in the study confirm the serious nature of eating dis orders. However. our results suggest that the efficacy of existing interven tions is questionable.