Abstract
The findings of a large number of outcome studies on bulimia nervosa published from 1985 to 2021 are summarized in this review. Follow-up periods varied from 3 months to 22 years after treatment or first assessment. Only a small number of studies reported outcome at different time points in an identical sample of individuals with bulimia nervosa. Eating disorder diagnoses followed different diagnostic systems, but all diagnoses covered the core symptoms of bulimia nervosa. Most studies included individuals who had received treatment for bulimia nervosa, while some studies collected samples from the community or extracted data from registries.
Outcome was reported mainly as the presence or absence of core symptoms like binge eating and inappropriate compensatory behavior, or as the presence of eating disorder diagnoses at follow-up. Remission from bulimia nervosa increased over the first 10 years after treatment. About two thirds of the individuals with bulimia nervosa will greatly improve or recover in the long run, with frequent relapses in between. A chronic course of bulimia nervosa was observed in about 15–20%. Ten years after treatment, recovery from bulimia nervosa gets increasingly unlikely. A small number of individuals crossed-over to another full eating disorder diagnosis and about 1–3% died. Compared to the general population, having a diagnosis of bulimia nervosa increased the risk of death by 50%. Only very little is known on the effects of bulimia nervosa on social adjustment. Impaired social adjustment seems to be correlated with symptom severity. From what can be concluded from the scarce findings on the course of bulimia nervosa in males, there seem to be no material differences in the outcome of bulimia nervosa in males and females.
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Quadflieg, N., Voderholzer, U., Fichter, M.M. (2023). Outcome of Bulimia Nervosa. In: Robinson, P., Wade, T., Herpertz-Dahlmann, B., Fernandez-Aranda, F., Treasure, J., Wonderlich, S. (eds) Eating Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-97416-9_89-1
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DOI: https://doi.org/10.1007/978-3-030-97416-9_89-1
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