What Factors Influence Full Recovery from Anorexia Nervosa?

Anorexia nervosa is a serious, potentially life-threatening illness that often has a long course. Although many people with anorexia nervosa fully recover, others will develop a chronic form of the condition which can end in death or severe medical complications.

Researchers are looking for factors that might help (or hinder) full recovery from anorexia. Identifying these factors can hopefully help medical and mental health professionals determine the best treatment for each person with the condition.

Full recovery is often defined as being completely free from all symptoms of the eating disorder and a return to a healthy body weight. It is also accompanied by an appropriate perspective on food, body image, and body weight.

Learn some of the factors that may influence whether or not someone may fully recover from anorexia nervosa. It is important to note that people who have potentially detrimental factors affecting them won't or can't make a full recovery.

Duration of Illness

One of the primary predictors for recovery from anorexia is a short duration of symptoms and illness prior to treatment. In other words, the longer a person has symptoms of anorexia before starting treatment and entering recovery, the more likely it is that the illness will become chronic or that medical complications will develop.

For this reason, eating disorders must be screened for in high-risk populations, and parents and other caregivers should not ignore symptoms.

Many patients do not believe they are ill and therefore may not think they need treatment.

Male patients and those from marginalized and underserved communities often don't receive early intervention and treatment for eating disorders.

Depression

Many people with eating disorders also have symptoms of one (or more) other mental health conditions, such as depression. It's not uncommon for people with anorexia nervosa to report they experienced symptoms of depression prior to the onset of the eating disorder. Others may have only developed additional mental health symptoms after their eating disorder started.

Medical and mental health professionals need to be prepared to identify and treat depression in addition to anorexia nervosa. A 2014 study found that persistent and chronic anorexia symptoms are more likely to develop in people who experienced symptoms of depression before they developed an eating disorder.

Relationship with Parents

Research has also demonstrated that people with supportive and positive parental relationships are more likely to achieve recovery. On the other hand, people who have a negative relationship with family, or who have extremely critical parents, appear to be more likely to experience anorexia nervosa as a chronic illness.

Providers should recognize that families with a child who has an eating disorder may appear to have poor relationships when they are actually responding to a crisis.

This underscores the importance of involving parents in the treatment process, whether through family therapy or family-based treatment.

Obsessive-Compulsive Disorder

As with depression, many people with anorexia nervosa also experience obsessive-compulsive disorder (OCD) alongside their eating disorder. Some research indicates the two conditions could share a genetic link.

Research has shown that co-existing OCD is linked with poorer outcomes in the recovery of anorexia nervosa. The link is yet another reason why it's necessary for treatment providers to screen for and address additional mental health symptoms in people with eating disorders.

Vomiting and Purging Behaviors

Binging and purging is a subtype of anorexia nervosa in which people engage in self-induced vomiting or other purging behaviors. It is similar to another eating disorder called bulimia nervosa

People with anorexia nervosa who binge and purge may also be diagnosed with the anorexia nervosa binge-eating/purging subtype.

Seeking Help

Anorexia recovery is possible and it's never too late to begin the process. If you or a loved one has anorexia nervosa, it's vital that you involve a team of knowledgeable, compassionate medical and mental healthcare professionals.

Seeking help from a provider who has experience treating eating disorders can give someone with an eating disorder and their family invaluable resources and support on the road to recovery

Anorexia Discussion Guide

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A Word From Verywell

Eating disorders can be difficult to recognize and even more complex to treat, but there is hope. Researchers continue to investigate factors that affect the course of anorexia nervosa.

New information will help develop better ways to identify and treat eating disorders, as well as the other mental health conditions that often accompany them. For people with anorexia nervosa and their families, working with an informed and compassionate team of medical and mental health professionals is crucial to positive recovery outcomes.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. NEDA. Statistics & Research On Eating Disorders. National Eating Disorders Association (NEDA).

  2. Errichiello L, Iodice D, Bruzzese D, Gherghi M, Senatore I. Prognostic factors and outcome in anorexia nervosa: a follow-up studyEat Weight Disord. 2016;21(1):73–82. doi:10.1007/s40519-015-0211-2

  3. Sonneville KR, Lipson SK. Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, socioeconomic background, and sex among college studentsInt J Eat Disord. 2018;51(6):518–526. doi:10.1002/eat.22846

  4. Keski-rahkonen A, Raevuori A, Bulik CM, Hoek HW, Rissanen A, Kaprio J. Factors associated with recovery from anorexia nervosa: a population-based study. Int J Eat Disord. 2014;47(2):117-23. doi:10.1002/eat.22168

  5. Franko D, Murray H, Mancuso C, Eddy K. Managing Severe and Enduring Anorexia Nervosa: A Clinician’s Guide. (Le Grange D, Hay P, Touyz S, Lacey H, eds.). New York: Routledge; 2016:19-20.

  6. Yilmaz Z, Halvorsen M, Bryois J, Yu D, Thornton L, Zerwas S, et al. Examination of the shared genetic basis of anorexia nervosa and obsessive-compulsive disorder [published online ahead of print, 2018 Aug 7]. Mol Psychiatry. 2018. doi:10.1038/s41380-018-0115-4

  7. Franko DL, Tabri N, Keshaviah A, Murray H, Herzog D, Thomas J, et al. Predictors of long-term recovery in anorexia nervosa and bulimia nervosa: Data from a 22-year longitudinal studyJ Psychiatr Res. 2018;96:183–188. doi:10.1016/j.jpsychires.2017.10.008

Additional Reading

By Susan Cowden, MS
Susan Cowden is a licensed marriage and family therapist and a member of the Academy for Eating Disorders.