Studies of the epidemiology of bulimia nervosa

Article Abstract:

Bulimia nervosa first appeared in the literature in the early 1970s and has since been included in the Diagnostic and Statistical Manual of Mental Disorders, third edition. This eating disorder is characterized by three primary features: recurrent episodes of overeating referred to as 'binges'; a variety of behaviors to control body weight and shape such as excessive dieting, exercising, self-induced vomiting, and taking diuretics or laxatives; and preoccupation with body weight and shape. Much interest has been aroused by this disorder, and research efforts have focused on estimating the prevalence of bulimia nervosa. These studies have concentrated on white females between the ages of 14 and 40 years; the prevalence in this population is estimated to be about 1 percent. This article has considered three additional aspects of bulimia nervosa: subgroups of individuals at high or low risk of developing the condition; longitudinal studies; and investigations of the change in prevalence over time. Preliminary data are available from some studies which have focused on subgroups such as athletes, diabetics, individuals with mental disorders, and people who are obese. A lower incidence of bulimia nervosa has been found among nonwhites and men. There have been some reports of this condition in individuals participating in sports activities which emphasize weight control such as horse racing and wrestling. Studies designed to follow the development and progression of bulimia nervosa over time have been performed but are, thus far, inconclusive. Four longitudinal studies have also been done, and two major observations were made: the eating disorder symptoms typically fluctuate in severity, and a subgroup of patients exists in which bulimia nervosa is persistent. It is recommended that research efforts be redirected from studying prevalence to gaining a better understanding of the condition, with more emphasis upon the cause and progression of bulimia nervosa and the risks for developing the disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Review of bulimia nervosa in males

Article Abstract:

Bulimia nervosa, characterized by binge eating followed by purging, fasting, or vigorous exercise to prevent weight gain, is said to affect 1 percent of adolescent girls and young adult women. In males, the incidence is not known but the disorder has been thought to be less common. There are methodological difficulties in assessing the incidence of bulimia in males. For instance, research shows that females are more likely than males to label binge-eating behavior as such, and research relies heavily on self-report of behavior. In a review of 24 studies that reported on bulimia in males, certain risk factors have consistently emerged. Age of onset seems to be later for males than for females, ranging from about 18 to 26 years of age, and obesity may be more prevalent in males than in females. In both sexes, dieting usually occurs before binging behavior sets in, but for men it seems that dieting is less of a risk factor than it is for women. This may be because men and women view their bodies differently, and men tend to be more satisfied with their bodies than women. Women and men are both at higher risk for bulimia if their occupations or sports interests emphasize body weight, and male bulimics have a higher rate of homosexuality than females do. Higher than expected rates of drug and alcohol abuse have been reported among male bulimics as well, which is consistent with findings for females. The clinical features of bulimia appear to be essentially the same for males and females. Treatment and outcome data for male bulimics are insufficient even for speculation, however. Biological, psychological, and cultural factors may account for the differences observed between male and female bulimics. Onset of puberty, for instance, is later for boys than for girls and may be related to the later onset of bulimia in males. It is recommended that future research analyze the characteristics of bulimia in males rather than adding to the wealth of prevalence studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Statistics, Men

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Update on the epidemiology of anorexia nervosa in a defined region of Switzerland

Article Abstract:

The authors first published an epidemiologic study of Swiss women with anorexia nervosa in The American Journal of Psychiatry in 1983. The subjects were all from the Zurich area and were randomly sampled between 1956 and 1975; three time intervals were represented: 1956 to 1958, 1963 to 1965, and 1973 to 1975. Data gathered included incidence of anorexia nervosa, age of onset, time period from onset to first hospitalization, and general illness profiles. This article provides an update of this information covering the period between 1983 and 1985. All the subjects were women and all were between the ages of 12 and 25 with a definite diagnosis of anorexia nervosa. The incidence of the disease was not significantly higher during this time period compared with the 1973 to 1975 period. However, a large increase was noted between the years 1956 and 1975. The cases which were reported between 1983 and 1985 included more women who also purged (induced vomiting or took laxatives), which suggests bulimia combined with the diagnosis of anorexia nervosa. The average age of onset was 16.8 years, and the interval of time between onset and first hospitalization was 2.4 years; both figures were comparable to previous findings. The patients were also categorized by socioeconomic status, which revealed an increase in the occupational status of the patients' fathers and a decrease in patient performance in school. The average weight of the patients was higher than that of patients assessed during earlier periods. Weight at onset of anorexia was higher than in earlier cases, indicating a possibility of preexisting eating disorders. In general, the overall illness profile remained constant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Switzerland, Anorexia nervosa

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