Abstract
Anorexia nervosa (AN) has a prolonged course of illness, making both defining recovery and determining optimal outpatient treatments difficult. Here, we report the types of treatments utilized in a naturalistic sample of adult women with AN in Texas. Participants were recruited from earlier studies of women with AN (n = 28) and in weight recovery following AN (n = 18). Participants provided information about both their illness and treatments during their most severe period as well as during the 2–6 years following original assessments. Based upon their baseline and follow-up clinical status participants were classified as remaining ill (AN-CC, n = 17), newly in recovery (AN-CR, n = 11), and sustained weight-recovery (AN-WR, n = 18). Utilization of health care institutions and providers were compared across groups. There were no differences in groups related to symptoms or treatments utilized during the severe-period. During the follow-up period, intensive outpatient programs were utilized significantly more by the AN-CC group than the other groups, and dietitians were seen significantly less by the AN-WR group. Medical complications related to the ED were significantly more common in the AN-CC group. All groups maintained similar levels of contact with outpatient psychiatrists, therapists, and primary care physicians. Current treatments remain ineffective for a subset of AN participants. Future prospective studies assessing medical health and comorbidities in AN may provide additional insights into disease severity and predictors of clinical outcome.
Highlights
Anorexia nervosa (AN) is a serious mental illness characterized by difficulties consuming sufficient calories to maintain body weight in conjunction with disturbances in self-perception
There were no differences in the distributions of subtypes of AN by group [AN bingepurge/restricting, AN-CC 9/8, AN-CR 5/6, AN-WR 11/7; X2(2) = 0.67, p = 0.71, V = 0.12]
The AN-CC group had an earlier age of first treatment than the AN-CR group [age of first treatment, AN-CC 17.8, AN-CR 22.7, AN-WR 18.5, F(2, 42) = 3.35, p = 0.045; post hoc AN-CC < ANCR, p = 0.05]
Summary
Anorexia nervosa (AN) is a serious mental illness characterized by difficulties consuming sufficient calories to maintain body weight in conjunction with disturbances in self-perception. This disease often begins in adolescence and young adulthood, the course of disease is prolonged and outcomes are poor (Eddy et al, 2017). A recent meta-analysis showed that treatment changed only short-term weight outcomes but did not significantly impact either short-term or long-term psychosocial outcomes or long-term recovery (Murray et al, 2018). There is little evidence that defines what is optimal outpatient treatment for adults with AN, and minimal data describing even the types of treatment utilized in the community in the United States
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