Towards an Improved Understanding of Severe and Enduring Anorexia Nervosa

There is increasing recognition that a significant proportion of people with anorexia nervosa have a severe and enduring course of illness (SE-AN). They have a markedly reduced life expectancy with the highest mortality rate of any mental illness. Anorexia Nervosa usually starts in adolescence and indeed is one the most common chronic illnesses of adolescence, with high levels of medical complications and health service use. Thus, the lifetime impact on individuals and health care systems is profound. Those living with SE-AN, are “entitled to dream of a better tomorrow” (Touyz & Hay Journal of Eating Disorders 2015 3:26). Whilst huge advances have been made in other severe enduring illnesses such as depression and cancer, research into AN lags behind, notably as there has only been one randomised controlled trial to date that has specifically focussed people with SE-AN.

Further research is urgently needed to improve understanding of processes underpinning the disorder, derive new treatments, and clarify conceptualisation and approach to management. People with SE-AN have for too long been under-researched whilst contending with poor quality of life, a poorly defined understanding, and a notable paucity of evidence-based treatments. This situation is in urgent need of redress. Thus, this Research Topic welcomes manuscripts pertaining to any aspect of this most challenging and complex form of eating disorder.