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This has been variously termed severe and enduring anorexia nervosa or longstanding anorexia nervosa (L-AN). Conflicting findings have hindered progress in distinguishing the nosological features of individuals with persistent illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242510923X_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aims to investigate the putative defining features of individuals reporting symptoms of L-AN, including consideration of their treatment trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242510923X_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study, drawing from a mixed-methods design, utilised a sample of symptomatic individuals who reported experiencing eating disorder treatment (\n                      <jats:italic>n<\/jats:italic>\n                      = 208). Several qualitative and quantitative data strands (a\u2013c) were embedded within a single, self-report questionnaire measuring eating disorder severity and treatment experiences. Between-group comparisons were used to compare those of shorter (&lt;3 years) and longer (&gt;7 years) duration of illness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242510923X_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No between-group differences were found in measures of severity, including body mass index (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), eating disorder symptom scores, psychological distress or perceived health-related quality of life. However, those with L-AN had a significantly higher number of mental and physical health comorbidities, longer treatment delay, greater number of episodes of treatment and poorer subjective ratings of their treatment experiences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242510923X_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Delineating L-AN by severity may be inappropriate; anorexia nervosa of any duration is a severe illness. This study suggests that treatments, or lack thereof,\u00a0may have an inadvertent impact on duration of illness. Future focus needs to be on reconceptualising L-AN and its treatments. Treatment refinements informed by lived experience are proposed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10923","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:25:09Z","timestamp":1766391909000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Key features of illness and treatment experiences in longstanding anorexia nervosa: qualitative descriptive study"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9312-9115","authenticated-orcid":false,"given":"Laura","family":"Kiely","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Sydney University"},{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Sydney University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillipa","family":"Hay","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Sydney University"},{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Sydney University"},{"name":"Camden and Campbelltown Hospitals, SWSLHD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Conti","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03t52dk35","id-type":"ROR","asserted-by":"publisher"}],"name":"Western Sydney University"},{"name":"Western Sydney University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"S205647242510923X_ref42","doi-asserted-by":"publisher","DOI":"10.1002\/erv.1056"},{"key":"S205647242510923X_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-018-0229-8"},{"key":"S205647242510923X_ref93","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20054"},{"key":"S205647242510923X_ref99","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170100407X"},{"key":"S205647242510923X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00038-9"},{"key":"S205647242510923X_ref68","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23323"},{"key":"S205647242510923X_ref76","doi-asserted-by":"publisher","DOI":"10.1177\/1468794106058877"},{"key":"S205647242510923X_ref82","doi-asserted-by":"publisher","DOI":"10.1007\/s10862-014-9441-2"},{"key":"S205647242510923X_ref11","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21182"},{"key":"S205647242510923X_ref108","volume-title":"Cognitive-Behavioral Therapy for Anorexia Nervosa. 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