Only half of the patients with eating disorders (EDs) fully recover. To increase these rates, knowledge about predictors is essential. Previous studies found that purging behaviors, BMI, ED duration, and depression, predicted symptomatic ED recovery. The current study investigated these four predictors for symptomatic improvement and the subjective experience of recovery.

Method

Participants who completed the baseline and second wave of the Netherlands Eating disorder Registry (NER) (N = 374), were categorized into: (1) Subjective recovery; (2) Clinical improvement; (3) Symptomatic recovery. Using regression analyses, it was investigated if the four baseline factors predicted recovery at wave two. Effects were compared among a binge-purging and restricting group.

Results

In total, 136 participants were subjectively recovered, 135 showed clinical improvement, and 70 were symptomatically recovered. Overlap occurred between definitions. Lower depression scores predicted subjective recovery (OR 0.77, p < .001) and clinical improvement (OR 0.80, p < .001), and shorter ED duration predicted all definitions (OR 0.99, p < .001; OR 0.99, p < .001; OR 0.99, p = .013). Similar effects were found in the binge-purging group.

Discussion

Our study emphasized that the same predictors, like depression, apply to symptomatic improvement and the personal experience of recovery. Depression appears an important factor during ED treatment.

Public significance

Recovery rates for EDs are low. To understand this, knowledge about predictors of ED recovery is essential. This study examined the effects of four established predictors across symptomatic improvement and subjective recovery (a more personal experience of recovery). Lower depression scores predicted both, indicating that depression appears important for multiple definitions of recovery and therefore warrants attention during ED treatment.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

Open Research

OPEN RESEARCH BADGES

This article has earned an Open Data badge for making publicly available the digitally-shareable data necessary to reproduce the reported results. The data is available at [insert provided URL from Open Research Disclosure Form].

DATA AVAILABILITY STATEMENT

Data will be available upon reasonable request.

Supporting Information

REFERENCES

Aardoom, J. J., Dingemans, A. E., Op't Landt, M. C. S., & Van Furth, E. F. (2012). Norms and discriminative validity of the eating disorder examination questionnaire (EDE-Q). Eating Behaviors, 13(4), 305–309. https://doi.org/10.1016/j.eatbeh.2012.09.002
10.1016/j.eatbeh.2012.09.002
PubMed Web of Science® Google Scholar
Ackard, D. M., Richter, S. A., Egan, A. M., & Cronemeyer, C. L. (2014). What does remission tell us about women with eating disorders? Investigating applications of various remission definitions and their associations with quality of life. Journal of Psychosomatic Research, 76(1), 12–18. https://doi.org/10.1016/j.jpsychores.2013.10.002
10.1016/j.jpsychores.2013.10.002
PubMed Web of Science® Google Scholar
Bardone-Cone, A. M., Alvarez, A., Gorlick, J., Koller, K. A., Thompson, K. A., & Miller, A. J. (2019). Longitudinal follow-up of a comprehensive operationalization of eating disorder recovery: Concurrent and predictive validity. International Journal of Eating Disorders, 52(9), 1052–1057. https://doi.org/10.1002/eat.23128
10.1002/eat.23128
PubMed Web of Science® Google Scholar
Bardone-Cone, A. M., Hunt, R. A., & Watson, H. J. (2018). An overview of conceptualizations of eating disorder recovery, recent findings, and future directions. Current Psychiatry Reports, 20(9), 79. https://doi.org/10.1007/s11920-018-0932-9
10.1007/s11920-018-0932-9
PubMed Web of Science® Google Scholar
Dawson, L., Rhodes, P., & Touyz, S. (2014). The recovery model and anorexia nervosa. Australian & New Zealand Journal of Psychiatry, 48(11), 1009–1016.
10.1177/0004867414539398
PubMed Web of Science® Google Scholar
de Vos, J. A., LaMarre, A., Radstaak, M., Bijkerk, C. A., Bohlmeijer, E. T., & Westerhof, G. J. (2017). Identifying fundamental criteria for eating disorder recovery: A systematic review and qualitative meta-analysis. Journal of Eating Disorders, 5, 34. https://doi.org/10.1186/s40337-017-0164-0
10.1186/s40337-017-0164-0
PubMed Web of Science® Google Scholar
Dingemans, A. E., van Son, G. E., Aardoom, J. J., Bruidegom, K., Slof-Op't Landt, M. C., & van Furth, E. F. (2016). Predictors of psychological outcome in patients with eating disorders: A routine outcome monitoring study. The International Journal of Eating Disorders, 49(9), 863–873. https://doi.org/10.1002/eat.22560
10.1002/eat.22560
PubMed Web of Science® Google Scholar
Dingemans, A. E., van Son, G. E., Vanhaelen, C. B., & van Furth, E. F. (2020). Depressive symptoms rather than executive functioning predict group cognitive behavioural therapy outcome in binge eating disorder. European Eating Disorders Review, 28(6), 620–632. https://doi.org/10.1002/erv.2768
10.1002/erv.2768
PubMed Web of Science® Google Scholar
Dingemans, A. E., Visser, H., Paul, L., & van Furth, E. F. (2015). Set-shifting abilities, mood and loss of control over eating in binge eating disorder: An experimental study. Psychiatry Research, 230(2), 242–248. https://doi.org/10.1016/j.psychres.2015.09.001
10.1016/j.psychres.2015.09.001
PubMed Web of Science® Google Scholar
Fairburn, C. G., & Beglin, S. J. (2008). Eating disorder examination questionnaire. Cognitive Behavior Therapy and Eating Disorders, 309, 313.
Google Scholar
Field, A. E., Sonneville, K. R., Micali, N., Crosby, R. D., Swanson, S. A., Laird, N. M., Treasure, J., Solmi, F., & Horton, N. J. (2012). Prospective association of common eating disorders and adverse outcomes. Pediatrics, 130(2), 289–295. https://doi.org/10.1542/peds.2011-3663
10.1542/peds.2011-3663
PubMed Web of Science® Google Scholar
Forman, S. F., McKenzie, N., Hehn, R., Monge, M. C., Kapphahn, C. J., Mammel, K. A., Callahan, S. T., Sigel, E. J., Bravender, T., Romano, M., Rome, E. S., Robinson, K. A., Fisher, M., Malizio, J. B., Rosen, D. S., Hergenroeder, A. C., Buckelew, S. M., Jay, M. S., Lindenbaum, J., & Rickert, V. I. (2014). Predictors of outcome at 1 year in adolescents with DSM-5 restrictive eating disorders: Report of the national eating disorders quality improvement collaborative. The Journal of Adolescent Health, 55(6), 750–756. https://doi.org/10.1016/j.jadohealth.2014.06.014
10.1016/j.jadohealth.2014.06.014
PubMed Web of Science® Google Scholar
Franko, D. L., Tabri, N., Keshaviah, A., Murray, H. B., Herzog, D. B., Thomas, J. J., Coniglio, K., Keel, P. K., & Eddy, K. T. (2018). Predictors of long-term recovery in anorexia nervosa and bulimia nervosa: Data from a 22-year longitudinal study. Journal of Psychiatric Research, 96, 183–188. https://doi.org/10.1016/j.jpsychires.2017.10.008
10.1016/j.jpsychires.2017.10.008
PubMed Web of Science® Google Scholar
Levallius, J., Roberts, B. W., Clinton, D., & Norring, C. (2016). Take charge: Personality as predictor of recovery from eating disorder. Psychiatry Research, 246, 447–452. https://doi.org/10.1016/j.psychres.2016.08.064
10.1016/j.psychres.2016.08.064
PubMed Web of Science® Google Scholar
Lock, J., Agras, W. S., Le Grange, D., Couturier, J., Safer, D., & Bryson, S. W. (2013). Do end of treatment assessments predict outcome at follow-up in eating disorders? International Journal of Eating Disorders, 46(8), 771–778. https://doi.org/10.1002/eat.22175
10.1002/eat.22175
CAS PubMed Web of Science® Google Scholar
Slof-Op't Landt, M. C. T., Dingemans, A. E., de la Torre, Y. R. J., & van Furth, E. F. (2019). Self-assessment of eating disorder recovery: Absence of eating disorder psychopathology is not essential. The International Journal of Eating Disorders, 52(8), 956–961. https://doi.org/10.1002/eat.23091
10.1002/eat.23091
PubMed Web of Science® Google Scholar
Smink, F. R., van Hoeken, D., & Hoek, H. W. (2013). Epidemiology, course, and outcome of eating disorders. Current Opinion in Psychiatry, 26(6), 543–548. https://doi.org/10.1097/YCO.0b013e328365a24f
10.1097/YCO.0b013e328365a24f
PubMed Web of Science® Google Scholar
Thompson-Brenner, H., Shingleton, R. M., Sauer-Zavala, S., Richards, L. K., & Pratt, E. M. (2015). Multiple measures of rapid response as predictors of remission in cognitive behavior therapy for bulimia nervosa. Behaviour Research and Therapy, 64, 9–14. https://doi.org/10.1016/j.brat.2014.11.004
10.1016/j.brat.2014.11.004
PubMed Web of Science® Google Scholar
Vall, E., & Wade, T. D. (2015). Predictors of treatment outcome in individuals with eating disorders: A systematic review and meta-analysis. The International Journal of Eating Disorders, 48(7), 946–971. https://doi.org/10.1002/eat.22411
10.1002/eat.22411
PubMed Web of Science® Google Scholar
Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.
10.1097/00005650-199603000-00003
PubMed Web of Science® Google Scholar
Wetzler, S., Hackmann, C., Peryer, G., Clayman, K., Friedman, D., Saffran, K., Silver, J., Swarbrick, M., Magill, E., & van Furth, E. F. (2020). A framework to conceptualize personal recovery from eating disorders: A systematic review and qualitative meta-synthesis of perspectives from individuals with lived experience. International Journal of Eating Disorders, 53(8), 1188–1203.
10.1002/eat.23260
PubMed Web of Science® Google Scholar
Wild, B., Friederich, H. C., Zipfel, S., Resmark, G., Giel, K., Teufel, M., Schellberg, D., Lowe, B., de Zwaan, M., Zeeck, A., Herpertz, S., Burgmer, M., von Wietersheim, J., Tagay, S., Dinkel, A., & Herzog, W. (2016). Predictors of outcomes in outpatients with anorexia nervosa-results from the ANTOP study. Psychiatry Research, 244, 45–50. https://doi.org/10.1016/j.psychres.2016.07.002
10.1016/j.psychres.2016.07.002
PubMed Web of Science® Google Scholar

Citing Literature

Volume56, Issue6

June 2023

Pages 1240-1245

Predictors of recovery in eating disorders: A focus on different definitions

Abstract

Objective

Method

Results

Discussion

Public significance

CONFLICT OF INTEREST STATEMENT

Open Research

OPEN RESEARCH BADGES

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Information

About Wiley Online Library

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Predictors of recovery in eating disorders: A focus on different definitions

Abstract

Objective

Method

Results

Discussion

Public significance

CONFLICT OF INTEREST STATEMENT

Open Research

OPEN RESEARCH BADGES

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Related

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley