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Int J Eat Disord. 2019 Dec;52(12):1353-1364. doi: 10.1002/eat.23151. Epub 2019 Aug 23.

Long-term outcomes in treated males with anorexia nervosa and bulimia nervosa-A prospective, gender-matched study.

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Schön Klinik Roseneck Affiliated with the, Medical Faculty of the University of Munich, Ludwig-Maximilians-University, Prien, Germany.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.



We report on the long-term outcome of males compared to females treated for anorexia nervosa (AN) or bulimia nervosa (BN).


A total of 119 males with AN and 60 males with BN were reassessed 5.8 ± 4.6 and 7.5 ± 5.9 years (respectively) after treatment and compared to matched female patients.


At follow-up, males with AN had a higher body weight than females. For AN, remission rates (40% males vs. 41% females) did not differ at follow-up. And at follow-up, more males (34%) than females (19%) had an eating disorder not otherwise specified (ED-NOS; p < .01). At follow-up of AN, there was no binge-eating disorder (BED) and obesity was rare. For BN, remission rates (44% males vs. 50% females) and frequency of AN, BN, BED and ED-NOS did not differ at follow-up. Males with AN scored lower than females at follow-up on most subscales of the Eating Disorder Inventory (EDI) and on somatization, obsessive-compulsive symptoms, and depression (Brief Symptom Inventory). Males with BN scored lower than females with BN on perfectionism and higher on interpersonal distrust (EDI) at follow-up.


Results from the scarce literature on males with ED are inconclusive regarding longer term outcome. In the present study, males with AN showed a slightly better outcome than females. In BN, outcome was about the same in males and females. According to our study, existing treatment is equally effective in both males and females. Additional research on the need of gender-specific diagnosis and therapy is required.


anorexia nervosa; bulimia nervosa; course; eating disorder; females; long-term; males; outcome


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