Standardized Definition of Recovery in Eating Disorders: A New Operationalization

Strategic Insights -

A new study published in the International Journal of Eating Disorders has made significant contributions to the understanding of recovery in eating disorders. The research, conducted by Hunna J. Watson and colleagues from the University of North Carolina Chapel Hill, aimed to develop a standardized definition of recovery that can be used in treatment outcome research. The study examined various combinations of physical, behavioral, and cognitive recovery criteria to identify the most empirically supported operationalization of eating disorder recovery.

Key Takeaways:

  • The study included 223 females with a history of eating disorders and 105 age-matched female controls who completed questionnaires, interviews, and weight/height measurements at baseline and approximately 1-year follow-up.
  • The researchers considered two approaches to assessing each of the following domains of recovery: physical (BMI 18.5 kg/m^2 or 19 kg/m^2), behavioral (no binge eating, purging, or fasting in the past 3 months), and cognitive (all four EDE-Q subscale scores within 1 standard deviation of age- and gender-matched norms).
  • The study found that operationalizations of recovery were more similar than different, with high rates of stability in recovery (77%-86%) and low relapse rates (7%-15%) over time.
  • The researchers proposed using a combination of physical, behavioral, and cognitive recovery criteria as a standardized operationalization of recovery for research purposes.
  • Specifically, they recommended using BMI 18.5 or 19 kg/m^2 (physical recovery), no binge eating, purging, or fasting over the past 3 months (behavioral recovery), and all four EDE-Q subscale scores within 1 standard deviation of age- and gender-matched norms (cognitive recovery).

Statistics:

  • 223 females with a history of eating disorders were included in the study.
  • 105 age-matched female controls were also included in the study.
  • Rates of stability in recovery ranged from 77% to 86% over time.
  • Relapse rates ranged from 7% to 15% over time.
  • The researchers considered 8 different operationalizations of comprehensive eating disorder recovery.

Sources:

  • Watson, H. J., Bardone-Cone, A. M., Walsh, E. C., Wash, L. K., Wallace, L. R., Zucker, N., & Bulik, C. M. (2025). Comparing Operationalizations of Eating Disorder Recovery Using a Comprehensive Lens: Physical, Behavioral, and Cognitive Domains. International Journal of Eating Disorders, 2025. Wiley: 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - www.wiley.com/; International Journal of Eating Disorders - onlinelibrary.wiley.com/journal/10.1002/(ISSN)1098-108X)