Bulimia nervosa and binge eating disorder have different courses and outcomes among young women, study results show. Specifically, the prognosis of women with bulimia nervosa is relatively poor, while the vast majority of women with binge eating disorder recover. Researchers from Oxford University, UK, conducted what is reportedly the first prospective study to compare the longer-term course and outcome of the two disorders. For five years, they studied two community-based groups of women, one comprised of 102 subjects with bulimia nervosa and the other of 48 subjects with binge eating disorder.
The participants, all of whom were between the ages of 16 and 35 years at recruitment, were assessed at 15-month intervals for issues including eating disorder features, general psychiatric symptoms, and social functioning.
Patients in both groups showed considerable initial improvement, but the binge-eating subjects fared better over the long term, according to the investigators. At 5-year follow-up, only 15% of the women initially diagnosed with binge eating disorder had any clinical eating disorder, compared with 49% of the bulimia group.
These findings have three main implications. "First," the scientists say, "they are relevant to the standing of binge eating disorders as a diagnostic concept." Retaining the distinction between bulimia nervosa and binge eating disorder is supported by the facts that the cohorts had different course and outcome and few patients moved across the two categories.
"Second," Dr. Fairburn's group notes, "the findings have a bearing on the clinical significance for prevalence figures for these disorders," since bulimia nervosa seems to carry a poorer prognosis than binge eating disorder. "Third," they conclude, "it is evident that further work is needed on the relationship between these disorders and obesity since weight gain is likely to occur in both conditions."
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