Eating disorders can be difficult to treat, and remission is difficult to assess. A recent systematic review in the Journal of Eating Disorders outlines new outcomes to be considered when assessing eating disorder recovery.
An eating disorder is a multi-faceted condition. It may have significant impacts on an individual’s quality of life, both personally and professionally. The current factors measured to determine recovery from eating disorders include remission or a change in the pathology of the individual and the treatment methods that utilize these criteria have proven effective for only some patients.
A study from the Netherlands published by the Journal of Eating Disorders addresses the disagreement in the scientific community over the criteria used to determine eating disorder recovery. The study incorporates psychological well-being in the criteria for recovery. Psychological well-being was defined using Dr. Carol Ryff’s six sub-categories: self-acceptance, environmental mastery, meaning in life, autonomy, positive relationships, and personal growth.
Research from eighteen studies was compiled to carry out a systematic review and qualitative meta-analysis. The contributors searched databases for published articles that focused on eating disorder recovery at any point in time. They then identified relevant concepts present in all 18 studies. Researchers used terms including ‘recovery’, ‘qualitative’, and ‘eating disorder’, ‘anorexia nervosa’, or ‘bulimia nervosa’. Since the studies in question were qualitative, the researchers utilized the Critical Appraisal Skills Programme (CASP) to assess the studies. Each study was analyzed in relation to the outlined description of psychological well-being.
A total of 286 participants were included in the study who averaged an age of 30.2 years. One hundred and sixty-three participants had been diagnosed with anorexia nervosa, 25 had been diagnosed with bulimia nervosa, eight individuals had been diagnosed with binge eating disorders, and 18 were diagnosed with both anorexia nervosa and bulimia nervosa at some point during their lifetime. The remaining 13 participants were diagnosed with an unspecified eating disorder. On average, the eating disorders had lasted 8.2 years. Based on the recovered individuals, the researchers calculated the value of each sub-category of psychological well-being using effect sizes.
The results showed that the effect sizes for autonomy, personal growth, positive relationships, and self-acceptance were significant. Those who were recovered from eating disorders overwhelmingly agreed that psychological well-being was fundamental to recovery. This means that supplementary measures of psychological well-being and resilience should be included in outcome assessments of eating disorder recovery.
The study concluded that along with the present criteria for eating disorder recovery, factors of psychological well-being should be considered as well. The information places importance on long-term health and accuracy of treatment methods, specifically pertaining to more complex conditions involving mental health. With detailed recovery criteria that emphasize all aspects of quality of life, complete treatments will ensure improved overall long-term health with a lower risk of relapse.
Written by Shrishti Ahuja, HBSc
Reference: 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(1). doi:10.1186/s40337-017-0164-0