Objective: To assess whether or not claims of an increase in the incidence of bulimic disorders are empirically justified. Method: Review of the epidemiological data informative to gauge time trends: Studies based on hospital records or registers, community surveys of bulimic disorders, questionnaire-based investigations. Results: Epidemiological studies conducted since 1980 do not show an upward trend in rates. Reports of increased rates among recent birth cohorts were unreliable and did not control for confounding comorbid disorders. Changes in diagnostic 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 keeping with this conservative conclusion, it is noted that high rates of dieting and body dissatisfaction were already reported 30 years ago among adolescent girls. 0 1996 by John Wiley & Sons, Inc.
Community Surveys of Bulimic Disorders
General population surveys have been carried out among both adolescent and adult samples to estimate the prevalence of bulimic disorders, defined as psychiatric disorders. Prevalence rates are reported either for a recent period or for the entire lifetime.
* Linear trends in proportions were computed by the present author. They were significant for lifetime history of bulimia ( p = ,011) and active bulimia ( p = .006), but not for lifetime history of "narrow" bulimia ( p = .11). The data are shown in Table 1 (Pope et al., 1984, p. 293).