title: Is bulimia nervosa increasing in frequency?
abstract: OBJECTIVE
  To assess whether or not claims of an increase in the incidence of bulimic disorders are empirically justified.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Denmark Hill, London.
authors.forename: E
authors.initials: E
authors.lastname: Fombonne
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002032:Bulimia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012737:Sex Factors