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Ask the Mental Health Expert Archives 2001-2004

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History of Anorexia

Q. I've just found out that the lady I intend to marry had a history of anorexia at around the age of 11 or so. She says that she's ok now (she's now 22) and she doesn't have any such problems at present. My question is... is it a good idea to go ahead and marry her? Would it be a problem later on? What are the chances of her having a relapse? And even if she doesn't have a relapse... would she be able to function properly?

A. I can't make predictions about the woman you intend to marry, but I can tell you that, in general, there's no reason to be terribly gloomy about individuals who have had anorexia nervosa (AN) in the past. Statistically, most studies have shown that about 60% of AN patients will show some degree of chronic or fluctuating disturbance over the years. But in one study of AN, 84 patients were followed over a period of 21 years (Zipfel et al, Lancet Feb. 2000). It was found that about half had achieved a full recovery from the illness, while only about 10% still met full criteria for AN.

Still, as a recent psychiatry textbook puts it, "It is impossible to predict course and outcome in any patient with any certainty." But even if the woman you intend to marry should have a recurrence of her eating disorder, that wouldn't be the end of the world, would it? She certainly could enter into treatment, which can often be very helpful. This would include psychotherapy, and possibly medication as well. In my experience, someone who has functioned well for more than 10 years, without evidence of AN or other serious emotional problems, has a good shot at staying reasonably well, and enjoying a happy, stable marriage.

I hope this turns out to be the case for you and your fiancee.

April 2001

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