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Is bulimia nervosa increasing in frequency?
1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Denmark Hill, London.
The International Journal of Eating Disorders
|April 1, 1996
Summary
Epidemiological data do not support claims of increased bulimic disorder incidence. Changes in diagnostic practices, not true increases, likely explain higher patient numbers. Body dissatisfaction was common decades ago.
Area of Science:
- Psychiatry
- Epidemiology
- Public Health
Background:
- Claims of increasing bulimic disorder incidence are widespread.
- Previous reports suggested rising rates in recent birth cohorts.
- Understanding true incidence trends is crucial for public health planning.
Purpose of the Study:
- To empirically evaluate the evidence for an increased incidence of bulimic disorders.
- To determine if observed increases in patient numbers reflect actual incidence changes or other factors.
Main Methods:
- Systematic review of epidemiological studies on bulimic disorders since 1980.
- Analysis of data from hospital records, community surveys, and questionnaire investigations.
- Assessment of time trends and birth cohort effects.
Main Results:
- Epidemiological studies since 1980 show no consistent upward trend in bulimic disorder rates.
- Reports of increased incidence in recent cohorts were found to be unreliable and lacked control for comorbidities.
- Observed increases in treated patients are likely attributable to changes in diagnostic criteria and healthcare seeking behaviors.
Conclusions:
- Current empirical evidence does not support the notion of secular changes in the incidence of bulimic disorders.
- High rates of dieting and body dissatisfaction were prevalent among adolescent girls even 30 years ago, suggesting long-standing concerns.
- Further research with robust methodologies is needed to confirm these findings.