What is recovery in adolescent anorexia nervosa?

OBJECTIVE: The principal aim of this study is to describe the types of problems faced in defining recovery from anorexia nervosa (AN) as well as to illustrate the magnitude that various definitions have on recovery rates for AN. METHOD: Comparative rates of recovery from AN using a range of definitions (percent ideal body weight, psychological recovery, and combinations of these variables) were calculated using long-term outcome data from a study of adolescents treated for AN. In addition, a Kaplan-Meier survival analysis was used to model recovery over the long-term follow-up period. RESULTS: Recovery rates varied highly, depending on the definition used, from 57.1% to 94.4%. Using survival analysis, the mean time to remission for weight (>85% ideal body weight) was 11.3 months, significantly shorter than for Eating Disorder Examination score recovery at 22.6 months (log rank = 16.1, p = 0.0001). CONCLUSION: Agreement of definitions of recovery may be dependent on specific goals of a particular study or treatment; however, in order to compare and contrast categorical outcomes, a consistent definition of recovery is needed in the literature. Both weight and psychological symptoms appear to be important in a definition of recovery.