Groundbreaking Swedish study reveals 30-year outcomes for adolescents with anorexia nervosa

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In a landmark study offering unprecedented insight into the long-term effects of anorexia nervosa, researchers at the Gillberg Neuropsychiatry Centre at the University of Gothenburg in Sweden followed a group of individuals diagnosed with the eating disorder during their teenage years in the 1980s. The findings—now presented in a doctoral thesis by PhD student and psychologist Sandra Rydberg Dobrescu, titled “Adolescent-Onset Anorexia Nervosa in the Acute Stage and After 30 Years”—illuminate recovery trajectories, life outcomes, and the enduring challenges faced by those affected.

Anorexia nervosa is a severe psychiatric disorder, predominantly affecting women, characterised by extreme food restriction, significant weight loss, and a distorted body image. It continues to carry one of the highest mortality rates among mental health conditions. However, taken together, the four separate studies present a more nuanced perspective, revealing that many individuals can—and do—recover, even after living with the illness for decades.

The studies followed 102 participants—51 individuals who had anorexia nervosa in adolescence and 51 matched control subjects—over a 30-year period. It is the only known research project worldwide to have followed a cohort of anorexia patients for such a long time and provides rare insight into the disorder’s natural progression outside of clinical settings.

Some of the key research findings:

• Recovery and life outcomes: A majority of those who had experienced anorexia had recovered by midlife. Levels of education, family formation, and number of children were similar between the anorexia and control groups, suggesting many former patients go on to lead stable, fulfilling lives.
• Persistent challenges: Despite these encouraging signs, the study found that about 20% of participants still struggled with active eating disorders three decades later. In addition, one in five showed reduced work capacity, and relapse remained a risk even after long periods of recovery.
• Predictive factors: Certain traits were associated with better outcomes. Teenagers who were slightly older when they developed anorexia, and those who exhibited perfectionistic tendencies before the onset of illness, had higher chances of recovery.
• Impact on next generation: A sub-study revealed concerning data about the children of mothers who had anorexia. These children tended to be born smaller and had increased risks of health issues related to immunity, metabolism, and hormone regulation.

The thesis also explored potential reasons why some individuals respond poorly to treatment. A separate analysis of adolescents treated at a specialised eating disorder clinic found that many had a tendency to focus on details rather than maintaining a broader perspective—traits often associated with autism and ADHD. This detail-focused thinking style may hinder engagement with treatment and could contribute to a longer illness course.

“Early identification of cognitive and neurodevelopmental traits linked to poorer prognosis could be key in tailoring treatment and preventing chronic illness,” noted doctoral student and psychologist Sandra Rydberg Dobrescu.

As anorexia nervosa remains a deeply complex disorder, this 30-year follow-up provides invaluable evidence that, while recovery is possible and even common, significant long-term challenges still exist for a notable portion of individuals. The study highlights the urgent need for early intervention, personalised treatment, and ongoing support for individuals experiencing relapses. 

The findings are expected to inform both clinical practice and policy decisions in the field of eating disorder treatment and mental health care.

Text by Anna Spyrou, Communications Officer

• Sandra Rydberg Dobrescu will be defending her thesis 23rd May 2025 at 13:00.
• This public defence is open to all and will be held in Swedish. 
• Address: Arvid Carlsson Lecture Hall, Medicinaregatan 3. Gothenburg,  413 90,  Sweden