A prospective test of the relation between weight change and risk for bulimia nervosa

Prospectively investigate whether weight gain or weight loss increases risk for onset of binge eating and purging in adolescent women.

Diagnostic interviews and direct measures of body mass were completed by 496 adolescent women annually for 8 years.

Substantial weight gain or weight loss during the study produced a sevenfold increase in risk for future onset of threshold or subthreshold bulimia nervosa (BN) relative to weight-stable participants, though the low incidence rate limited statistical power. Those who showed onset of threshold/subthreshold BN experienced greater increases in weight in the 2 years before onset of their eating disorder relative to healthy comparison participants.

This is the first prospective study to demonstrate that weight gain and weight loss may both increase risk for future onset of bulimic pathology. Results suggest that young women who have difficulty limiting their dietary intake are at increased risk for BN, an eating disorder characterized by loss of control over eating.