Background During theyears1988^ 1993 the primarycare incidence of anorexia nervosa inthe UKremained stable, butthe incidence of bulimia nervosa increased threefold. Aims To determinewhether the incidence of anorexia nervosa remained stable, and thatof bulimia nervosa continued to increase, in theyears

Declaration of interest None. Trends in disease incidence are important for conceptualising disease aetiology and planning health services. Several studies have used meta-analysis to determine whether eating disorder incidence has changed over time, although these have largely focused on anorexia nervosa. Prior results indicate a small global increase in the incidence of anorexia nervosa throughout the 20th century (Keel & Klump, 2003), with a stable European incidence since the 1970s (Hoek & van Hoeken, 2003). Only three studies have specifically focused on trends in the incidence of bulimia nervosa, owing to its later recognition as a diagnostic category and the tendency to report prevalence rather than incidence. However, prior work found a threefold increase in the UK primary care incidence of bulimia nervosa between 1988 and 1993 (Turnbull et al, 1996). This leaves two important questions: has the incidence of anorexia nervosa remained stable, and is the incidence of bulimia nervosa continuing to rise as dramatically as previously reported?