Comparing Operationalizations of Eating Disorder Recovery Using a Comprehensive Lens: Physical, Behavioral, and...

Area of Science:

• Psychiatry
• Clinical Psychology
• Eating Disorder Research

Background:

• Standardized definitions of recovery are essential for advancing eating disorder (ED) treatment outcome research.
• Current research lacks a universally accepted operationalization of ED recovery, hindering comparative analysis and progress.

Purpose of the Study:

• To identify the most empirically supported operationalization of ED recovery by examining combinations of physical, behavioral, and cognitive recovery criteria.
• To assess the concurrent and predictive validity of different ED recovery definitions.

Main Methods:

• A cohort of 223 females with a history of ED and 105 controls were assessed at baseline and 1-year follow-up.
• Physical recovery criteria included BMI ≥ 18.5 kg/m² or ≥ 19 kg/m².
• Behavioral recovery involved no binge eating, purging, or fasting in the past 3 or 6 months.
• Cognitive recovery was assessed using EDE-Q subscale or global scores within 1 SD of norms.

Main Results:

• Operationalizations of ED recovery demonstrated high similarity.
• Recovery rates showed significant stability over time, ranging from 77% to 86%.
• Relapse rates were consistently low, between 7% and 15%.

Conclusions:

• A proposed standardized operationalization for ED recovery in research includes BMI ≥ 18.5 or 19 kg/m² (physical), no disordered behaviors in the past 3 months (behavioral), and cognitive criteria met via EDE-Q subscale scores within 1 SD of norms.
• This definition integrates physical, behavioral, and cognitive domains for a holistic assessment of recovery.
• The findings support a robust and stable definition of ED recovery for research applications.