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Anorexia Recovery Criteria — MRCPsych Paper B MCQ

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ModerateEating DisordersAnorexia Recovery CriteriaMRCPsych Paper B

A 19-year-old woman with anorexia nervosa has received treatment from a specialist eating-disorder service for 2 years. Her BMI is 19.5, her weight has been stable for 6 months and she has no current medical instability. She still experiences some body-image disturbance. The multidisciplinary team is reviewing whether to end specialist treatment. Which approach is most consistent with NICE NG69?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Do not base discharge on BMI alone; assess physical and psychological progress, relapse risk and follow-up needs before ending specialist treatment

Explanation lettering: E = shown as C · C = shown as E

B is correct. A healthy and stable BMI is an important marker of physical improvement, but NICE states that discharge should not be based solely on reaching a healthy weight. The review should also consider eating-disorder psychopathology, functioning, progress against treatment objectives, relapse risk and arrangements for ongoing support or re-referral. Residual body-image disturbance therefore requires assessment but does not automatically mandate indefinite specialist treatment. A and D incorrectly treat a BMI threshold or duration of weight stability as a complete definition of recovery. C sets an unnecessarily absolute requirement: complete disappearance of every body-image concern is not a NICE discharge criterion. E is incorrect because patient preference should inform shared decision-making but does not replace risk assessment and appropriate discharge planning.

Reference: National Institute for Health and Care Excellence. Eating disorders: recognition and treatment (NG69), sections 1.3 and 1.11, 2017; updated 2020. https://www.nice.org.uk/guidance/NG69/chapter/recommendations