Self-reported history of anorexia nervosa and current quality of life: findings from a community-based study

Abstract

Purpose

To evaluate the impact of a lifetime history of anorexia nervosa (AN) on current quality of life (QoL) and eating disorder (ED) symptomatology.

Method

3,034 participants from a randomly selected sample of households in the Australian population were interviewed for current ED symptoms and QoL (SF-36).

Results

89 participants (2.9 %) reported a history of AN, 73 of whom were female. These participants scored lower on six of the eight subscales on the SF-36, including all of the mental health subscales, and were more likely to report binge eating and extreme weight or shape concerns than participants who did not report a history of AN. On the other hand, participants who reported a history of AN were less likely to be overweight. None of the participants who reported a history of AN met current criteria for AN; however, one met criteria for bulimia nervosa non-purging subtype and four met criteria for binge eating disorder. The endorsement of current ED symptoms was found to moderate the impact of a history of AN on scores of the social functioning and role limitations due to emotional health SF-36 subscales, such that participants who reported a history of AN scored lower on these subscales if they also reported current ED symptoms.

Conclusions

A history of AN has a deleterious impact on current QoL, despite remittance from the disorder. This may be explained in part by the presence of certain ED symptoms, including objective binge eating and the persistence of extreme weight and shape concerns.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Jenkins, P. E., Hoste, R. R., Meyer, C., & Blissett, J. M. (2011). Eating disorders and quality of life: A review of the literature. Clinical Psychology Review, 31(1), 113–121.

    PubMed  Article  Google Scholar 

  2. 2.

    Abraham, S. F., Brown, T., Boyd, C., Luscombe, G., & Russell, J. (2006). Quality of life: Eating disorders. Australian and New Zealand Journal of Psychiatry, 40(2), 150–155. doi:10.1111/j.1440-1614.2006.01762.x.

    PubMed  Article  Google Scholar 

  3. 3.

    Bamford, B., & Sly, R. (2010). Exploring quality of life in the eating disorders. European Eating Disorders Review, 18(2), 147–153.

    PubMed  Article  Google Scholar 

  4. 4.

    Munoz, P., Quintana, J. M., Las Hayas, C., Aguirre, U., Padierna, A., & Gonzalez-Torres, M. A. (2009). Assessment of the impact of eating disorders on quality of life using the disease-specific, Health-Related Quality of Life for Eating Disorders (HeRQoLED) questionnaire. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 18(9), 1137–1146.

    Article  CAS  Google Scholar 

  5. 5.

    Doll, H. A., Petersen, S. E., & Stewart-Brown, S. L. (2005). Eating disorders and emotional and physical well-being: Associations between student self-reports of eating disorders and quality of life as measured by the SF-36. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 14(3), 705–717.

    Article  Google Scholar 

  6. 6.

    Mond, J. M., Hay, P., Rodgers, B., Owen, C., & Beumont, P. (2005). Assessing quality of life in eating disorder patients. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 14(1), 171–178.

    Article  CAS  Google Scholar 

  7. 7.

    Padierna, A., Quintana, J., Arostegui, I., Gonzalez, N., & Horcajo, M. (2000). The health-related quality of life in eating disorders. Quality of Life Research, 9(6), 667–674. doi:10.1023/a:1008973106611.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Arkell, J., & Robinson, P. (2008). A pilot case series using qualitative and quantitative methods: Biological, psychological and social outcome in severe and enduring eating disorder (anorexia nervosa). International Journal of Eating Disorders, 41(7), 650–656.

    PubMed  Article  Google Scholar 

  9. 9.

    Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2007). Health service utilization for eating disorders: Findings from a community-based study (Vol. 40, pp. 399–408). Wiley Subscription Services, Inc., A Wiley Company.

  10. 10.

    Cachelin, F. M., & Striegel-Moore, R. H. (2006). Help seeking and barriers to treatment in a community sample of Mexican American and European American women with eating disorders. International Journal of Eating Disorders, 39(2), 154–161.

    PubMed  Article  Google Scholar 

  11. 11.

    Hart, L., Granillo, M., Jorm, A., & Paxton, S. (2011). Unmet need for treatment in the eating disorders: A systematic review of eating disorder specific treatment seeking among community cases. Clinical Psychology Review, 31, 727–735.

    PubMed  Article  Google Scholar 

  12. 12.

    Mond, J. M., Hay, P. J., Darby, A., Paxton, S. J., Quirk, F., Buttner, P., et al. (2009). Women with bulimic eating disorders: When do they receive treatment for an eating problem? Journal of Consulting and Clinical Psychology, 77(5), 835–844.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Hay, P. (2003). Quality of life and bulimic eating disorder behaviors: Findings from a community-based sample (Vol. 33, pp. 434–442). Wiley Subscription Services, Inc., A Wiley Company.

  14. 14.

    Wade, T. D., Bergin, J. L., Tiggemann, M., Bulik, C. M., & Fairburn, C. G. (2006). Prevalence and long-term course of lifetime eating disorders in an adult Australian twin cohort. Australian and New Zealand Journal of Psychiatry, 40(2), 121–128. doi:10.1111/j.1440-1614.2006.01758.x.

    PubMed  Article  Google Scholar 

  15. 15.

    Wade, T., Andrew, H., Abraham, S., Treloar, S., Martin, N. G., & Tiggemann, M. (1996). Assessing the prevalence of eating disorders in an Australian twin population. Australian and New Zealand Journal of Psychiatry, 30, 845–851.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Bulik, C. M., Sullivan, P. F., Tozzi, F., Furberg, H., Lichtenstein, P., & Pedersen, N. L. (2006). Prevalence, heritability, and prospective risk factors for anorexia nervosa. Archives of General Psychiatry, 63(3), 305–312. doi:10.1001/archpsyc.63.3.305.

    PubMed  Article  Google Scholar 

  17. 17.

    Government of South Australia, Department of Health. (2008). Health Omnibus Survey 2008. http://www.health.sa.gov.au/pros/Default.aspx?tabid. Accessed 18 March 2011.

  18. 18.

    Fairburn, C. G., & Cooper, Z. (1993). The eating disorder examination. In C. G. Fairburn & G. Wilson (Eds.), Binge eating: Nature, assessment and treatment (12th ed.). New York: Guildford Press.

    Google Scholar 

  19. 19.

    Ware, J., Kosinski, M., & Keller, S. (1994). SF-36 physical and mental health summary scales: A user’s manual. Boston: The Health Institute.

    Google Scholar 

  20. 20.

    McCallum, J. (1995). The SF-36 in an Australian sample: Validating a new, generic health status measure. Australian Journal of Public Health, 19, 160–166.

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Australian Bureau of Statistics (ABS). (1995). National Health Survey: SF-36 population norms, Australia. Canberra.

  22. 22.

    World Health Organisation (WHO). (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. WHO Technical Report Series, 894, 1–253.

  23. 23.

    Mond, J. M., Hay, P. J., Rodgers, B., & Owen, C. (2007). Recurrent binge eating with and without the ‘undue influence of weight or shape on self-evaluation’: Implications for the diagnosis of binge eating disorder. Behaviour Research and Therapy, 45(5), 929–938.

    PubMed  Article  Google Scholar 

  24. 24.

    Björk, T., Clinton, D., & Norring, C. (2011). The impact of different outcome measures on estimates of remission in a 3-year follow-up of eating disorders. European Eating Disorders Review, 19(1), 2–11. doi:10.1002/erv.1031.

    PubMed  Article  Google Scholar 

  25. 25.

    American Psychiatric Association (APA). (2000). Diagnostic and statistical manual for mental disorders (4th ed., text revision ed.). Washington DC: American Psychiatric Association.

  26. 26.

    Mond, J., & Arrighi, A. (2011). Gender differences in perceptions of the severity and prevalence of eating disorders. Early Intervention in Psychiatry, 5, 41–49.

    PubMed  Article  Google Scholar 

  27. 27.

    González-Pinto, A., Inmaculada, F., Cristina, R., de Corres Blanca, F., Sonsoles, E., Fernando, R., et al. (2004). Purging behaviors and comorbidity as predictive factors of quality of life in anorexia nervosa. International Journal of Eating Disorders, 36(4), 445–450. doi:10.1002/eat.20058.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The study was funded by a University of Western Sydney School of Medicine seeding grant to Professor Hay. Ms Mitchison is supported by a University of Western Sydney Postgraduate Research Award.

Conflict of interest

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to D. Mitchison.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mitchison, D., Hay, P., Mond, J. et al. Self-reported history of anorexia nervosa and current quality of life: findings from a community-based study. Qual Life Res 22, 273–281 (2013). https://doi.org/10.1007/s11136-012-0157-z

Download citation

Keywords

  • Anorexia nervosa
  • Quality of life
  • Population
  • Eating disorders
  • Community-based study