Objective: To develop a screening tool for the identification of bulim
ia in ambulatory practice. Design: Administration of a 112-item questi
onnaire about eating and weight-control practices to women with known
bulimia and to healthy control patients. Questions were compared with
DSM-III-R criteria of bulimia as a ''gold standard.'' Setting: Self-he
lp group for eating disorders and hospital-based primary care practice
. Subjects: Thirty of 42 women with known bulimia met DSM-III-R criter
ia for current bulimia, and 124 of 130 control patients met the criter
ion of no history of an eating disorder. Main results: Thirteen indivi
dual questions discriminated between bulimic subjects and control subj
ects with a sensitivity and specificity of >75%. When these questions
were entered into a stepwise logistic model, two questions were indepe
ndently significant. A ''no'' response to the question ''Are you satis
fied with your eating patterns?'' or a ''yes'' response to ''Do you ev
er eat in secret?'' had a sensitivity of 1.00 and a specificity of 0.9
0 for bulimia. The positive predictive value, based on a 5% prevalence
, was 0.36. Conclusions: A set of two questions may be as effective as
a more extensive questionnaire in identifying women with eating disor
ders, and could be easily incorporated into the routine medical histor
y obtained from all women.