• Pamela K Keel, David J Dorer, Debra L Franko, Safia C Jackson, and David B Herzog.
• Department of Psychology, E11 Seashore Hall, University of Iowa, Iowa City, Iowa 52242, USA. pamela-keel@uiowa.edu
• Am J Psychiatry. 2005 Dec 1; 162 (12): 2263-8.

ObjectiveThe authors sought to evaluate patterns and predictors of relapse among women with eating disorders.MethodInterviews were conducted biannually to annually to assess symptoms of eating disorders, axis I disorders, treatment, and psychosocial function on a weekly basis for women diagnosed with anorexia nervosa (N=136) or bulimia nervosa (N=110) and prospectively followed for 9 years. At the last follow-up, 229 (93%) of the subjects had been retained in the study group.ResultsRelapse occurred in 36% of the women with anorexia nervosa and 35% of the women with bulimia nervosa. Women with intake diagnoses of anorexia nervosa, restricting subtype, tended to develop bulimic symptoms during relapse, whereas women with intake diagnoses of anorexia nervosa, binge-purge subtype, or bulimia nervosa tended to return to bulimic patterns during relapse. Greater body image disturbance contributed to a risk of relapse in both eating disorders, and worse psychosocial function increased the risk of relapse in bulimia nervosa.ConclusionsThese results may explain the long-term efficacy of interpersonal therapy for bulimia nervosa and suggest that focused body image work during relapse prevention may enhance long-term recovery from eating disorders.

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