The lifetime prevalence of Bulimia Nervosa among women is approximately 1%-3%; the rate of occurrence of this disorder in males is approximately one-tenth of that in females.
Specific Culture, Age, and Gender Features
Bulimia Nervosa has been reported to occur with roughly similar frequencies in most industrialized countries, including the United States, Canada, Europe, Australia, Japan, New Zealand, and South Africa. Few studies have examined the prevalence of Bulimia Nervosa in other cultures. In clinical studies of Bulimia Nervosa in the United States, individuals presenting with this disorder are primarily white, but the disorder has also been reported among other ethnic groups.
In clinic and population samples, at least 90% of individuals with Bulimia Nervosa are female. Some data suggest that males with Bulimia Nervosa have a higher prevalence of premorbid obesity than do females with Bulimia Nervosa.
Course
Bulimia Nervosa usually begins in late adolescence or early adult life. The binge eating frequently begins during or after an episode of dieting. Disturbed eating behavior persists for at least several years in a high percentage of clinic samples. The course may be chronic or intermittent, with periods of remission alternating with recurrences of binge eating. However, over longer-term follow-up, the symptoms of many individuals appear to diminish. Periods of remission longer than 1 year are associated with better long-term outcome.
Familial Pattern
Several studies have suggested an increased frequency of Bulimia Nervosa, of Mood Disorders, and of Substance Abuse and Dependence in the first-degree biological relatives of individuals with Bulimia Nervosa. A familial tendency toward obesity may exist, but this has not been definitively established.