The risk of a first degree relative of a proband for developing the disease is 10 times that of the general population. Many patients become chronic, and the disease brings about a degree of social handicap comparable to schizophrenia. Certainly, because it usually occurs at the crucial stage in the victim's physical, psychological and social development, it causes serious impairment of functioning and interferes with education, work training, adaptation to peer relationships, sexual relationships and separation from the family of origin. Persistent psychiatric morbidity is common, especially dysthymia, major depression and obsessive-compulsive disorder. The disease leads to brain atrophy and a disorder of myelination, and it may have a persistent effect on cognition.
Cardiac arrhythmias are a common cause of sudden death in anorexia nervosa patients.
Long-term physical morbidity is also common and serious. Growth retardation is present in some patients who have an early onset of disease. Anovular infertility is common in some women who have only partially recovered. Osteopaenia leading to osteoporosis is a serious complication of the active disease, but may also have long-term effects because bone mineralization in women terminates with the menopause. Those who have not accumulated sufficient bone in younger life are prone to developing osteoporosis with ageing earlier than their peers.