The long-term outcome of 49 adolescent girls hospitalized for the treatment of anorexia nervosa on a pediatric service was determined by personal interview an average of 80 +/- 21 months after admission to the hospital. The mean age at follow-up was 22.7 years. Between admission to the hospital and follow-up, body weight increased, on average, from 72.1% to 96.1% of ideal. Amenorrhea occurred in all subjects, but menstruation began or resumed in 80% of patients after hospitalization, at a mean body weight 90.3% +/- 6.5% of ideal. A total of 15 pregnancies resulted in 2 elective abortions, 3 ongoing pregnancies, and 10 healthy newborns. No subject who desired to become pregnant was unable to conceive. Almost half of the subjects (22 of 45) acquired binge eating patterns after hospitalization. Overall, 86% had a satisfactory outcome. These data indicated that adolescents with anorexia nervosa can be successfully treated with a developmentally oriented, multidisciplinary approach that includes inpatient and outpatient management based in pediatrics.