Outcome of Anorexia Nervosa

Patients who either significantly overestimated (n = 17) or underestimated (n = 6) their body shape were selected for further investigation from a series of 33 consecutive inpatients diagnosed as having anorexia nervosa. Their cognitive, affective, and optative body images and their assessment of the physique of a normal weight for height person were measured using a videocamera with a distorting lens on two occasions, 5 weeks apart. Weight gain was monitored on a daily basis. There was no significant difference in the rate of weight gain between the two groups. Although the underestimators significantly improved their cognitive response, the overestimators failed to do so. The clinical implications of these findings are discussed.

Section: Discussionmentioning

confidence: 91%

Does over- or underestimation of body shape influence response to treatment in patients with anorexia nervosa?

Touyz

Beumont

Collins³

1988

“…When there has been a history of anorexia nervosa, weight gain and body shape changes accompanying pregnancy can provoke extreme distress (Crisp, 1984). Pregnancy after anorexia nervosa is infrequently reported, occurring in less than 10% of patients (Hsu, 1980;Hsu, Crisp, & Harding, 1979;Tolstrup, Brinch, Isager, Nielsen, Nystrup, Severin, & Olesen, 1985) and may require induction of ovulation (Hart, Kase, & Kimball, 1970). We describe two cases, different from the four pregnancies with spontaneous ovulation previously described (Abraham, Beumont, Booth, & Smith, 1981;Ho, 1985;Strimling, 1984;Weinfeld, Dubay, Burchell, Millerick, & Kennedy, 1977): both gained weight during pregnancy and had normal-weight babies.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy after anorexia nervosa

Rand

Willis

Kuldau

1987

Pregnancies of two women with a history of anorexia nervosa are described. Anxieties and fears of obesity were greatest during the first trimester and the second postpartum month. Disturbed eating behaviors gradually diminished during pregnancy but were augmented approximately 6 weeks after delivery. One woman received regular emotional support and dietary counseling from obstetrical staff during her pregnancy. Neither woman received counseling during the postpartum crisis. Supplemental antenatal and postnatal counseling for women with eating disorders is recommended.

“…Those patients from social classes 4 and 5 had a much poorer prognosis (70% showing little or no improvement with treatment compared with 32% of those from social classes 1 and 2). This finding of a worse prognosis for the lower social class subject was confirmed by Hsu, Crisp, and Harding (1979), although no relationship between prognosis and social class was discovered by Theander (1970) or Morgan and Russell (1975). Crisp, Kalucy, Lacey, and Harding (1977) suggest that a working class background confers a protection to anorexia nervosa in adolescence and that, where it occurs in the lower social classes, the precipitating psychopathology has to be more extreme.…”

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confidence: 95%

“…A younger age at onset was found to confer a better pronosis by Theander (1970), Hsu et al (1979), and Morgan and Russell (1975), although Dally (1969) found a relatively poor outcome in those falling ill before 14. Chronicity at presentation was similarly found to be related to poor prognosis by Morgan and Russell (1975) and Hsu et al (1979). These authors and Starky and Lee (1969) also found a relationship between poor prognosis and lowest-ever body weight during illness.…”

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confidence: 99%

“…These authors and Starky and Lee (1969) also found a relationship between poor prognosis and lowest-ever body weight during illness. The bulimic subtype (bulimia, vomiting, and laxative misuse) has been found to be related to poor prognosis by Hsu et al (1979) and Theander (1970). Garfinkel, Moldofsky, and Garner (1977) also found that the higher the rating of bulimia, vomiting, and laxative abuse on a four-point scale, the worse the prognosis.…”

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confidence: 99%

See 1 more Smart Citation

Social class and prognosis in anorexia nervosa

Gowers

McMahon

1989

Social class and clinical features were recorded for 100 consecutive cases of anorexia nervosa presenting to the St George's Hospital eating disorders department. A definite skew towards the higher social classes was discovered, but this was less marked than at the time of a similar study in the same department 10 years ago. Low social class has been reported as a poor prognostic indicator, but in this study, it was not related to other prognostic factors. The possible expanations are discussed.