An integrative quantitative model of factors influencing the course of anorexia nervosa over time

Objective: To identify factors influencing the course of anorexia nervosa (AN) over time. Method: Former female patients with AN (36 remitted and 24 nonremitted) and 31 healthy females responded to standardized interviews and self-rating questionnaires. Remitted patients maintained normal eating, normal weight, and regular menses for the past 12 months. Patients not fulfilling these criteria were considered nonremitted. Results: Using logistic regression, we identified that number of hospitalizations, duration of ambulatory treatment, past vegetarianism, past anxiety, and childhood sexual abuse differentiated remitted from nonremitted patients, predicting nonremission. A similar analysis identified that elevated follow-up vegetarianism and eating-related concerns and lower body mass index (BMI) differentiated remitted from nonremitted patients, contributing to nonremission. Univariate analyses identified that remitted patients had elevated anxiety and eating-related obsessionality compared with the controls, suggesting these variables to potentially predispose to AN. Discussion: Elevated anxiety and eating-related obsessionality may increase the risk for the development of AN and for nonremission.