Many adults who suffered from anorexia nervosa as teenagers cannot work now due to psychiatric disorders. A follow-up 18 years after the onset of anorexia has shown that one in four are on disability benefit or have been signed off sick.

However, the long-term follow-up by the Sahlgrenska Academy, University of Gothenburg, shows some encouraging results.

The study initiated in 1985 studied a total of 51 teenagers with anorexia nervosa together with an equally large control group of healthy persons. The groups have been investigated and compared several times as the years have passed.

This study is unique in an international perspective being the only study in the world that reflects the natural course of anorexia nervosa in the population.

Eighteen years after the start of the study, three women have still not recovered from anorexia, 13 people (around 25%) are on disability benefit or have been signed off sick for more than six months due to an eating disorder or other psychiatric disorders. Thirty-nine percent have at least one other psychiatric disorder, in addition to the eating disorder. The most common of these is obsessive compulsive disorder.

The results also contain some positive surprises. Previous studies have shown that anorexia is a diagnosis with a very poor prognosis, with as many as one in five patients dying as a result of the disease. In contrast, there has not been a single death among the subjects of the Swedish study.

Infertility is also a common complication for adult women who have had anorexia, as are increased risks of giving birth prematurely and of post-natal depression. The women in the two groups in this study have had essentially the same number of children, but the women who have had anorexia were younger when they had their first child. Such children had a lower birth weight than children of women in the control group.

None of the women who had had children still suffered from an eating disorder, but they did worry more about whether their babies were putting on weight.