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Structural magnetic resonance imaging studies have documented reduced gray matter in acutely ill patients with anorexia nervosa to be at least partially reversible following weight restoration. However, few longitudinal studies exist and the underlying mechanisms of these structural changes are elusive. In particular, the relative speed and completeness of brain structure normalization during realimentation remain unknown. Here we report from a structural neuroimaging study including a sample of adolescent/young adult female patients with acute anorexia nervosa (n = 47), long-term recovered patients (n = 34), and healthy controls (n = 75). The majority of acutely ill patients were scanned longitudinally (n = 35): at the beginning of standardized weight restoration therapy and again after partial weight normalization (> 10% body mass index increase). High-resolution structural images were processed and analyzed …