Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia

By Kelly D. Brownell; John P. Foreyt | Go to book overview

15
Outcome and Prognosis
of Anorexia Nervosa

George I. Szmukler and Gerald F. M. Russell

For the clinician, a knowledge of the likely outcome for a patient with a disorder is of great value. It helps in the formulation of management, particularly if it is likely to be long term, and in advising the patient and relatives as to what they may expect for the future.

Most disorders seen by psychiatrists are characterized by considerable variability in outcome, and anorexia nervosa is no exception. A number of comprehensive reviews in this areas6,8,15 reveal that outcome varies from full recovery to a chronic severe illness. As the majority of patients are female, the feminine gender will be used in the text when referring to an individual patient. There will be a section on male patients at the end of this chapter.


What Is a Good Outcome?

The question of what represents a good outcome in anorexia nervosa is not a straightforward one. The answer varies from one authority to the next and depends to a large degree on assumptions about the etiology of the disorder and the nature of the illness "process."

At least three possibilities can be considered: First, the illness comprises the basic syndrome of deliberate weight loss, amenorrhea, and a psychopathology concerning a morbid fear of "fatness." There are perhaps important predisposing factors but these are distinct from the illness process

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