Overall Quality of Life and Subjective Experiences as Novel Predictors of Long-Term Recovery

A recent study found that overall quality of life and subjective experiences should be considered predictive factors in long-term recovery.

A study from the Department of Neuroscience, Drug Research and Child Health Department, University of Florence, Italy aimed to “challenge a notion of recovery in eating disorders (EDs) that is exclusively based on weight restoration or behavioral changes.” This novel study recommended that, in addition to weight restoration, reduction in binge eating and dietary normalization factors related to body image, the overall quality of life and subjective experiences must be taken into account as predictive factors when monitoring progress and working toward recovery of patients with ED.

The study further defined a predictive factor for long-term recovery as the resumption of menstruation by the end of a treatment intervention and noted that sexual functioning is not commonly regarded as a factor predictive of outcome for patients with EDs. Lead Researcher Giovanni Castellini, MD, PhD, hypothesized that a psychopathological assessment, including factors such as sexual functioning and reversal of amenorrhea, might provide researchers and clinicians with information relating to the long-term recovery process.

Presentation of Research Findings: Quality of Life

The study was recently presented at the 30th European College of Neruopsychopharmacology Congress as having identified novel predictors for recovery. As stated in Medscape Medical News, “The researchers studied 39 AN (anorexia nervosa) and 40 BN (bulimia nervosa) patients to examine the role of sexuality as a moderator of recovery and to identify factors associated with the restoration of regular menstruation and sexual function.”

These patients underwent individualized CBT for one year. They were then assessed at the end of treatment, at the two-year post-treatment mark, and for a three-year follow-up. The study reports: “At the end of CBT, 22 (56.4%) AN patients and 23 (57.5%) BN patients were considered to have recovered. Two years later, at the three-year follow-up, 19 (48.7%) AN and 24 (60.0%) BN patients were considered to have recovered.” At the time of study completion, both AN and BN study participants reported experiencing significant improvements in sexual functioning after CBT, although the greatest improvements were recorded for AN patients. Interestingly, this was measured by a scale that assessed body uneasiness and restraint. The researchers also found that among AN patients, the pattern of recovery at the end of CBT differed between those with and those without amenorrhea. This difference remained consistent at the 3-year follow-up

What do these results mean? How can these findings be utilized within the field?

As hypothesized by Dr. Castellini, those who had resumed menstruation by the end of treatment had a greater improvement in body mass index and nutritional panels at the end of CBT. This was not seen in those who had not resumed menstruation. Such findings may help in determining future intervention strategies that include novel factors and predictors of recovery aside from those previously identified in traditional weight restoration programs. This study suggests that factors related to psychosexual functioning, body image, and subjective experiences may hold more importance than previously considered when thinking critically about longer term recovery.