The internet. Such a wonderful tool which aids in my ability to expand my intellect while sitting on my ass. Makes you ponder how many geniuses are out there sitting in Lazy-Boys and not front and centre at the University lecture…

Been reading quite a few articles about the psychological construct of bulimia nervousa, how disorders evolve and switch to another – anorexia to bulimia, to over eating and so on and so forth. Finding it all very fascinating, especially when the common theme for the RESULTS / CONCLUSION section reads along the lines of….

“One-quarter of a century of specific research in bulimia nervosa shows that the disorder still has an unsatisfactory outcome in many patients. More refined interventions may contribute to more favorable outcomes in the future.”

That quote is pulled from an interesting article titled The Outcome of Bulimia Nervosa: Findings From One-Quarter Century of Research by Hans-Christoph Steinhausen, M.D., Ph.D., D.M.Sc., and Sandy Weber, Cand.Phil. Now, with that many extra letters after their names, I assume these folks have the capacity to conduct factual data collection on a medical level. Impressive.

It’s a large text to dive through so I will highlight some points I found of particular interest – though I encourage all who dabble on my blog to read the text fully and conduct research about eating disorders as much as possible. Learn about what is happening to your body, and learn to listen to the signs. Listen to your body and your mind.

“In conclusion, the present comprehensive review of one-quarter of a century of outcome research shows that bulimia nervosa remains a serious disorder with unsatisfactory recovery and improvement rates and high rates of patients who continue to have chronic eating disorder problems and other comorbid psychiatric disorders over extended periods of their lives. Future research efforts could benefit from more collaborative and prospective studies based on large unselected samples and standardized assessment procedures using a common set of operationalized criteria of outcome. Refined study designs should particularly focus on the role of intervention in the long-term outcome of the disorder so that research might also identify beneficial effects on the course of the individual patient.”

“According to the present review, crossover to other eating disorders in the course of bulimia nervosa is very common. However, as a result of differences in the design of the outcome criteria of the studies, it was difficult to identify precisely the mean rate of crossover diagnoses, which was between a 10% and 32% range, depending on the criteria for the outcome. Obviously, the most common crossover at follow-up evaluations was to eating disorder not otherwise specified, followed by anorexia nervosa, and the least common crossover was to binge eating disorder. However, the low rate of binge eating disorder may be partially the result of underreporting because the term was not yet introduced when many of the older outcome studies were performed.

With a mean crude mortality rate of 0.32%, including a number of deaths not caused by bulimia nervosa, bulimia nervosa was definitely less fatal than anorexia nervosa, which resulted in a mean crude mortality rate of 5% in the review by Steinhausen (8). However, the frequencies of comorbid psychiatric disorders were high for both disorders. Affective and neurotic/anxiety disorders ranked highest, and there was a sizable proportion of patients with personality disorders at follow-up evaluations. Although the crude figures for comorbid disorders were higher for anorexia nervosa, these differences should not be overestimated because many studies did not clearly indicate the criteria for assessment or diagnosis.”