Q. A few years ago the subject of bulimia was constantly splashed across the covers of women’s magazines. Lately I haven’t seen anything about it. Has the problem subsided?
A. At least one survey has suggested that the behaviors associated with bulimia may be on the decline. Researchers sound a note of caution, however, that bingeing and purging could be replaced by excessive exercise among those who are particularly dissatisfied with their bodies.
When bulimia first emerged as a popular topic, original estimates of its prevalence may have been too high, since the criteria used to define it were overly broad. For instance, sometimes it was the existence – but not the frequency- of bingeing and purging that was measured.
Seeking to discover whether these behaviors were on the decline, Craig Johnson and his colleagues from Northwestern University repeated a survey of more than 1,200 female high-school students conducted five years earlier. The second group included nearly 1,100.
Good news first
In 1981, researchers found that 4.1 percent of the women met criteria for bulimia (but these criteria were somewhat broader than revised standards now in use). In 1986, that figure had dropped to 2.0 percent. Significantly fewer students binged, used diet pills or reported that there were times when they couldn’t stop eating.
Concern about weight and the need to go on a diet had fallen as well. Fewer of the students believed they were overweight, or that their family and friends thought they were overweight. Fewer were on a diet and they felt less pressure from family and friends to start one. Scores on a psychological test which measures drive for thinness dropped, too.
Now, the worrisome side
Scores on another psychological test that measures body dissatisfaction did not change. Dissatisfaction correlates with low self-esteem and personal ineffectiveness. The researchers suggest that some young women will seek other solutions to counter their perceptions, and that exercise in the “pursuit of strength” will produce a set of side effects related to exercise abuse. Whether the researchers’ prediction is correct, or whether interventions to alter their prophecy can be developed, remains to be seen.
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.