Eating Disorders: Anorexia Nervosa and Bulimia

E MERGING scientific evidence of the increasing prevalence of eating disorders, anorexia nervosa and bulimia in particular, necessitates that physicians be prepared both to diagnose and treat these disorders appropriately. Current estimates indicate that anorexia nervosa and bulimia affect 10% to 15% of adolescent girls and young women, and estimates of the prevalence of bulimia among college women range as high as 19% (1). However, despite increasing public attention to such eating disorders, many physicians are unfamiliar with both the increased prevalence and the appropriate approaches to diagnosis and treatment. Unfamiliarity with these disorders clearly limits a physician’s ability to identify anorexia nervosa or bulimia in his or her patients. Two problems are of particular concern: First, the physician unfamiliar with these diseases may inadvertently overlook their role as etiologic agents in other presenting medical problems, thereby missing the opportunity to address the root cause of a particular ailment. Second, the physician may overlook the presence of an eating disorder in an otherwise apparently healthy patient, thereby missing the opportunity to counsel the patient and treat the disorder early in its development. Herzog and Copeland (2) have recently summarized characteristics of the disorders as follows: