Within five years of regaining a healthy weight, the anorexic twins were virtually indistinguishable from their healthy co-twins or healthy women in the general population in terms of psychological symptoms and self esteem.

However, learning to deal with body shape and weight-related concerns usually took five to 10 years.

The researchers noted study limitations that included retrospective assessment of lifetime diagnoses by phone, incomplete recall, and lack of face-to-face contacts, which may have led to an underestimation of lifetime prevalences.

The five-year clinical recovery rates were similar for the detected and undetected cases and detection of anorexia by the health care system had no association with prognosis in the study. However, the authors noted that the impact of treatment outcome could not be directly assessed in this study "because case detection does not necessarily imply proper treatment."

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