Prognosis

The prognosis for anorexia is best when identification and treatment begin early in the illness course, and when full restoration of weight is achieved. Longer duration of follow-up and younger age at onset, are associated with better outcomes. (1)

Approximately 75% of adolescent patients with anorexia go on to achieve full recovery, although the time taken to get to this point may be up to 5 years. (2)

A poor prognosis is predicted by the need for hospitalisation and onset in adulthood. (3)

Mortality rates are far higher than for other psychiatric illnesses. They appear to be higher in people with lower weight during their illness and those presenting between 20-29 years of age. The average annual risk of mortality has been calculated to be 0.59% per year in females (4).

Deaths are due primarily to medical complications or suicide. (5)

Reference:

1. Steinhausen HC. The outcome of anorexia nervosa in the 20th century. Am J Psychiatry. 2002 Aug;159(8):1284-93.
2. Strober M, Freeman R, Morrell W. Long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study. Int J Eat Disord. 1997 Dec;22(4):339-60.
3. Jagielska G, Kacperska I; Outcome, comorbidity and prognosis in anorexia nervosa. Psychiatr Pol. 2017 Apr 30;51(2):205-218.
4. NICE. Eating disorders: recognition and treatment. NICE guideline NG69. Published May 2017, last updated December 2020
5. Nielsen S, Vilmar JW. What can we learn about eating disorder mortality from eating disorder diagnoses at initial assessment? A Danish nationwide register follow-up study using record linkage, encompassing 45 years (1970-2014). Psychiatry Res. 2021 Sep;303:114091.