Binge-eating, self-induced vomiting and laxative abuse: a community study

Following a television documentary on bulimia nervosa, people who thought that they had this type of eating problem were asked to complete a confidential questionnaire. 579 women who fulfilled self-report diagnostic criteria for bulimia nervosa were thereby identified. These women closely resembled patients with bulimia nervosa, although the age range was wider. They had grossly disturbed eating habits and almost half vomited at least daily. Laxative abuse was also common. Although almost two-thirds had been overweight in the past, the majority had a weight within the normal range. A minority had previously fulfilled diagnostic criteria for anorexia nervosa. On standardized measures, these women had abnormal attitudes to their weight and shape, as well as significant levels of psychiatric symptomatology. Nearly three-quarters thought that they definitely needed professional help, yet only a third had ever been referred for psychiatric treatment. Using data from this sample and an independent sample of 499 probable bulimia nervosa cases, the significance of three issues relating to the diagnosis of bulimia nervosa were examined: laxative abuse, the frequency of self-induced vomiting, and a history of anorexia nervosa.