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Possible predictors of longer-term recovery from eating disorders

Are we there yet? For people on the road to recovery from a psychiatric illness, such as the eating disorder anorexia nervosa, this can be a difficult question to answer. Until recently, we knew little about the physical and mental signs of recovery from an eating disorder, or how these signs vary among people with different eating disorders.

Now, researchers have identified some of the harbingers of long-term recovery from eating disorders. These findings are significant because they may help researchers and clinicians recognize when treatment for an eating disorder is successful.

The research team, led by James Lock, MD, director of the Stanford Child and Adolescent Eating Disorder Program at Lucile Packard Children's Hospital, examined data from five clinical trials of treatments for anorexia nervosa, bulimia nervosa and binge eating disorder. The investigators reviewed the treatment outcomes of patients to identify the mental and physical changes associated with a recovery that lasted six, twelve, or twenty-four months. The details and findings of the study were recently published online in the International Journal of Eating Disorders, and are summarized in an article from DailyRX.

I spoke with Lock to learn more about the work and how these findings may aid researchers and clinicians treating eating disorders. A key finding of this study, Lock explained, is that there are some mental and physical changes that researchers and clinicians can measure in patients that predict a longer-term recovery. "It’s also interesting that the predictors of longer-term recovery differ among different disorders and different age groups," Lock told me.

Lock explained why some of the results differed between adolescents and adults:

Sadly there were few predictors in adults, because so few recover. The analogy is to consider the recovery rates of patients with stage 1 cancer versus stage 4 cancer. Few patients with stage 4 cancer would recover because the disease had progressed. The same is true for chronic diseases, such as eating disorders.

One unexpected finding was related to the importance of cognitive changes in people being treated for binge eating disorders. They found that the best predictor of recovery from binge eating disorder was a global change in the patient’s eating-related psychopathology (i.e., the way the patient thinks about food) by the end of their treatment for binge eating disorder. This result was surprising because behavioral change alone was not enough to bring about recovery for patients with binge eating disorder.

Lock explained that this study was retrospective (i.e., done after the clinical trials were completed), so the next step is to study patients as they are being treated for eating disorders to see if the predictors identified in this study are truly good predictors.

"This study should encourage researchers consider these predictors seriously when running clinical trials," Lock said. "Clinicians can also use these cut-points as a way to give patients some way of knowing how they are doing at end of treatment and how they will do at follow up."

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Study: Higher caloric diets are safe and reduce length of stay in hospitalized teens with anorexiaExamining the benefits of estrogen therapy for girls with anorexiaEating-disorder hospitalizations declineExploring the connection between food and brain function and How anorexia is striking what many consider to be an unlikely group: boys and young men

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