Long-Term Course and Outcome

Many people know the definitions of anorexia nervosa, bulimia nervosa, purging and
binge-eating disorders. But not many people know about the long-term course and outcome of
these terms. Research suggests that learning more about the long-term course and outcome on
eating disorders will improve diagnostics measures and the understanding of treatment (Keel,
2017). Learning a lot about eating disorders, the prevalence, and the long-term course and
outcome are significant today because the number of people with eating disorders are growing.
There are a lot of factors that lead to eating disorders such as social media, body shaming,
families that judge upon weight, and even peers who seek for attractiveness. Among the
disorders, anorexia nervosa is associated with the highest risks of premature death among
psychiatric disorders (E.C. Harris & Barraclough, 1998). Anorexia has a high mortality rate and
is popular among the other eating disorders. Many people do not understand the long-term
course and outcome of anorexia, so being aware of the information help seeks treatment and
helps other people become aware of whats going on with people who have eating disorders.
Bulimia nervosa is the next highest among the disorders with the highest mortality rates.
Anorexia Nervosa: Mortality, Recovery, Relapse, Crossover, and Prognostic Factors
Anorexia has been common today in the United States. Many children suffer from anorexia due
to many body dissatisfaction from peers, families, and social media. Because many youths and
even adults suffer from anorexia nervosa, it has been a common eating disorder today. Body
image associates with anorexia and many people with anorexia nervosa have suffered from it.
Many other people are not well informed about the population that are affected by anorexia.
Chapter 11 was a great overview on long-term course and outcome of anorexia nervosa, the
highest risk of premature death among psychiatric disorders.
Mortality
Anorexia nervosa has affected many young people. About 5% of individuals diagnosed
with AN have died. Many researchers understand the mortality rate by using a standardized
mortality ratio where the observed number of people with AN to the expected number of deaths
in a matched population (Keel, 2017). Not only AN has a great toll due to lack of nutrients and
food because of the intense fear of gaining weight or becoming fat even though underweight
(Cash & Smolak, 2011), but AN lead to an increased risk of suicide. According to researchers, 1
in 5 individuals with AN have committed suicide. People with AN have shown that those who
committed suicide use highly lethal methods that would have been fatal even if their physical
health is at risk towards death. People with AN are most affected by starvation where medical
attention is needed, poor psycho function, alcohol use disorders, and longer duration of follow-
up are factors of high mortality rates. Other factors associated with suicide attempts in AN
include purging, depression, substance abuse, and a history of physical or sexual abuse (Franko
& Keel, 2006).
Recovery
 Many people with anorexia nervosa has had prolonged process that could take years to
recover from. For a 12-month follow up recovery, only about 9.1% of people with AN have been
found to be in remission. But for a 2-5 year follow-up, about 45% of people with AN have had
remission. At a long-term follow up, many people with AN have had remission. For many people
in recovery, its a long journey but 46% of them recover, 33% have improved but have remaining
symptoms and 20% have not recovered (Keel, 2017).
Relapse
In trying to overcome a disorder, relapse is relevant to the process of trying to find
treatment. It is stated that 51% of patients with AN have had readmission over the course of a
follow up (Keel, 2017). Many women tend to relapse, which is about 40$ who have had retrieved
full recovery. Many people who recover from AN have had a consequence of developing other
eating disorders, which are known as crossovers.
Crossovers
Crossovers is when you had a eating disorder transitioning into having another eating
disorder. Crossing over can be found in both the recovery and relapse stage. Many women who
has AN have developed binge-eating disorders and purging over time. 2-34% of people with AN
transition to a different eating disorder (Keel, 2017). Many crossovers happen due to many
people who have suffered from depression, substance abuse, and other diagnosis.
Prognostic Factors
Although there is no prognostic factor that has been found in many outcomes of AN, 13
studies have suggested that an older age of AN onset is related to the worse prognosis and 14 had
no significant association. It is also found that 14 studies suggest that a longer duration of
symptoms before treatment is associated with a poor prognosis of AN. Longer treatment and the
need for treatment has proven the worst possible outcome with those with anorexia nervosa.
Conclusion
Many treatments such as CBT (cognitive behavioral therapy) has proven a positive effect
for people with AN. A lot of people who have AN that are underweight deny the fact that they
have anorexia nervosa so its difficult for them to admit and to seek treatment or for help.