Long-term outcome of bulimia nervosa

Background: Since bulimia nervosa's introduction to the psychiatric nomencl ature in 1979, data concerning long-term outcome have been largely unavaila ble. Methods: Women with the diagnosis of bulimia nervosa between 1981 and 1987 who participated in 1 of 2 studies were located and invited to participate in follow-up assessments. Results: More than 80% of the women from these studies participated in foll ow-up assessments and the re suits represent findings for 173 women. More t han 10 years following presentation (mean +/-SD length of followup, 11.5 +/ - 1.9 years), 11% of this sample met full criteria for bulimia nervosa, and 0.6% met full criteria for anorexia nervosa. An additional 18.5% met crite ria for eating disorder not otherwise specified, and 69.9% of this sample w ere either in full or in partial remission. For predictive factors, only th e duration of the disorder at presentation and history of substance use pro blems demonstrated prognostic significance. Baseline treatment condition wa s not associated with remission of disordered eating symptoms by the follow -up assessment. Conclusions: The findings suggest that the number of women who continue to meet full criteria for bulimia nervosa declines as the duration of follow-u p increases; approximately 30%, however, continued to engage in recurrent b inge eating or purging behaviors (incidence rate, 0.026 cases per person-ye ars). A history of substance use problems and a longer duration of the diso rder at presentation predicted worse outcome.