Key Takeaways
Extended Takeaways
- Using a stringent definition of recovery as a PSR score of ≤ 2 for 52 consecutive weeks, the study still found long-term recovery in 62.8% of anorexia nervosa and 68.2% of bulimia nervosa, which can help clinicians frame prognosis without lowering the bar for remission.
- For bulimia nervosa, the median time to recovery during the first wave was estimated at 3.8 years, and recovery was 68.2% at both 9-year and 22-year follow-up, consistent with the article's conclusion that recovery in bulimia nervosa tends to occur earlier rather than continuing to rise over later decades.
- Relapse after earlier recovery remained clinically relevant over 22 years: 10.5% of patients with anorexia nervosa and 20.5% of patients with bulimia nervosa who were recovered at Wave 1 were no longer recovered at Wave 2, supporting long-term monitoring even after sustained remission.
- In anorexia nervosa, achieving 52 consecutive weeks of recovery by Wave 1 was strongly associated with recovery at Wave 2 (OR = 10.5; 95% CI, 3.77-29.28; McNemar χ21 = 31.39; P < .01), and this association remained present when early recovery was defined as 26 or 13 consecutive weeks.
- Recovered participants had lower mean Eating Disorder Examination Questionnaire scores than nonrecovered participants in both diagnoses, and quality-of-life gains were broader in anorexia nervosa than in bulimia nervosa, where only 1 domain differed significantly, reminding clinicians that symptom remission and functional recovery may not progress in parallel.
- At 20 to 25 years of follow-up, 176 of 228 survivors were re-interviewed, and multiple imputation procedures were used to include all participants presumed to be alive who had missing data at Wave 2 in the analyses.
