Bulimia Long-Term Prognosis — MRCPsych Paper B MCQ

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ModerateEating DisordersBulimia Long-Term PrognosisMRCPsych Paper B

A 22-year-old woman with bulimia nervosa asks about her long-term prognosis. Which statement most accurately reflects contemporary evidence about outcome at approximately 10 years or longer?

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Reveal the answer and explanation

Correct answer: B — About two-thirds recover; a minority have a chronic course

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

B is correct. Contemporary pooled evidence suggests that approximately two-thirds of people with an eating disorder have recovered by follow-up of 10 years or longer, with chronicity in roughly one-fifth. A longitudinal study specifically involving bulimia nervosa similarly found about 68% recovery by 9 years. These are approximate estimates because studies use differing diagnostic, behavioural and psychological definitions of recovery. A substantially underestimates recovery, whereas C is excessively optimistic because a clinically important minority remain symptomatic. D is incorrect because recovery can occur well beyond the first 2 years. E is incorrect because substantial longitudinal evidence exists, although methodological heterogeneity limits the precision of counselling for an individual patient.

Reference: Solmi M et al. Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis. World Psychiatry. 2024;23:124–138. https://pubmed.ncbi.nlm.nih.gov/38214616/