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Outcome in bulimia nervosa

P K Keel1, J E Mitchell

  • 1Department of Psychology, University of Minnesota, Minneapolis 55455, USA.

The American Journal of Psychiatry
|March 1, 1997
PubMed
Summary

Long-term outcomes for bulimia nervosa (BN) show about 50% recovery within 5-10 years, but the disorder may be chronic for some. Relapse risk decreases over time, though treatment may speed initial recovery.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Eating Disorders Research

Background:

  • Bulimia nervosa (BN) is a significant eating disorder with variable long-term outcomes.
  • Understanding prognostic factors is crucial for effective intervention and patient management.

Purpose of the Study:

  • To synthesize existing data on the long-term outcomes of individuals diagnosed with bulimia nervosa.
  • To identify prognostic factors influencing recovery, relapse, and mortality in BN patients.

Main Methods:

  • A systematic review of 88 studies was conducted.
  • Studies included follow-up assessments of bulimic subjects at least 6 months post-presentation.
  • Data were analyzed for mortality, recovery, relapse, crossover, and prognostic variables.

Main Results:

  • The crude mortality rate was 0.3%, likely underestimated due to study limitations.
  • 5-10 years post-presentation, approximately 50% of women recovered, while 20% still met BN criteria.
  • Around 30% experienced relapse, with risk declining after 4 years; impulsivity may indicate poorer outcomes.

Conclusions:

  • Treatment may accelerate initial recovery but does not significantly alter outcomes beyond 5 years.
  • Long-term prognosis for bulimia nervosa remains uncertain for a subset of individuals.
  • Bulimia nervosa may represent a chronic condition for some women.

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