Pre-menarchal bulimia nervosa

Although pre-pubertal anorexia nervosa has been well described, pre-pubertal bulimic behaviour in the context of this disorder appears to be uncommon. There have been no published reports of pre-pubertal bulimia nervosa occurring independently. Of 323 patients with bulimia nervosa attending an eating disorders research clinic between 1980 and 1989, the authors identified six patients who described pre-menarchal binge eating in the absence of a concurrent history of anorexia nervosa or massive obesity. Three (0.93%) of these patients described a pre-menarchal onset of bulimia nervosa, but there was no evidence that they were pre-pubertal. The implications of these findings are discussed.