Purpose <p>Anorexia nervosa (AN) is one of the most severe mental disorders in adolescence, yet it generally has a favourable long-term prognosis. However, evidence on the long-term labour market outcomes of AN is scarce and has several key limitations. This study aimed to provide a comprehensive assessment of the current long-term labour market outcomes of AN, examining unemployment, sickness absences, and income up to age 33.</p> Methods <p>Utilizing data from the Northern Finland Birth Cohort 1986, linked to national registers, we compared unemployment days, sickness absences, and income between individuals with AN (<i>n</i> = 165) and the rest of the cohort (control group, CG; <i>n</i> = 4884) using the Welch’s t-test and two-part regression models. The analyses were stratified by sex.</p> Results <p>Compared to the CG, both males and females with AN had lower cumulative income in 2011–2016. AN was associated with a greater number of unemployment days among both males and females who had any unemployment days. No significant differences in sick days in 2011–2019 were found between individuals with AN and the CG in either sex.</p> Conclusion <p>This study highlights the association between AN and poor labour market outcomes, particularly regarding income accumulation. More effective strategies are needed to identify and support individuals with AN, especially males, who tend to experience worse outcomes. Increasing awareness of AN among students and in workplaces, enhancing collaboration between services, and implementing early, cost-effective interventions are essential for improving labour market prospects.</p>