Bulimia 10-Year Prognosis — MRCPsych Paper B MCQ

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ModerateEating DisordersBulimia 10-Year PrognosisMRCPsych Paper B

In long-term follow-up studies of women diagnosed with bulimia nervosa, which approximate outcome profile is most consistent with findings 5–10 years after presentation?

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Correct answer: D — 50% fully recovered; 20% still met full diagnostic criteria

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

B is correct. Bulimia-nervosa-specific follow-up evidence indicates that approximately half of patients have fully recovered 5–10 years after presentation, while nearly one-fifth continue to meet full diagnostic criteria. The remainder may have residual or relapsing symptoms or diagnostic crossover, so they should not automatically be classified as having a single uniform form of partial recovery. Options A and E substantially underestimate full recovery and overestimate persistent bulimia nervosa. Options C and D are excessively optimistic for this follow-up interval. Estimates vary between cohorts because definitions of recovery, treatment exposure and ascertainment differ; therefore these figures should be understood as approximate group-level prognosis rather than an individual prediction.

Reference: Keel PK, Mitchell JE. Outcome in bulimia nervosa. American Journal of Psychiatry. 1997;154(3):313–321. https://pubmed.ncbi.nlm.nih.gov/9054777/