IS BULIMIA-NERVOSA INCREASING IN FREQUENCY

Objective: To assess whether or not claims of an increase in the incid ence of bulimic disorders are empirically justified. Method: Review of the epidemiological data informative to gauge time trends: Studies ba sed on hospital records or registers, community surveys of bulimic dis orders, questionnaire-based investigations. Results: Epidemiological s tudies conducted since 1980 do not show an upward trend in rates. Repo rts of increased rates among recent birth cohorts were unreliable and did not control for confounding comorbid disorders. Changes in diagnos tic and referral practices are likely to account for higher numbers of patients seen in specialized treatment centers. Discussion: Although based on a limited number of studies, the empirical evidence does not support secular changes in the incidence of bulimic disorders. In keep ing with this conservative conclusion, if is noted that high rates of dieting and body dissatisfaction were already reported 30 years ago am ong adolescent girls. (C) 1996 by John Wiley & Sons, Inc.