Introduction

Anorexia nervosa (AN) and bulimia nervosa (BN) pose significant health problems for female adolescents and young adult women. The unique combination of psychological issues and physical impairment and an often prolonged course disrupt psychological and physical growth at a crucial developmental period, with sometimes lasting effects on long-term health.

AN typically has its onset in adolescence and rarely in childhood. The incidence of AN is low, 4.2 cases per 100,000 population [1-5], and point prevalence estimates range between 0.1% and 1% in adolescent female populations and from 0.004% to 0.01% in adolescent males. A higher prevalence compared to the incidence suggests that AN rarely remits spontaneously and does not respond easily to treatment. Affected young people, even if they ultimately recover, may be exposed to many years of suffering. In fact AN is now the third most common chronic condition among adolescent girls in the US, after obesity and asthma [1,6]. The cost of long-term disability to health and welfare services due to chronic AN can be significant [7].

BN is a disorder of late adolescence and young adulthood. Incidence rates for BN are 12.2 per 100,000 population [8]. One-year, lifetime and point prevalence estimates for BN are higher than for AN: they are 1.5%, 2.6-2.8% and 4.2%, respectively, for females, and lifetime prevalence is 0.4% for males [9-12]. In outcome studies of hospitalized and clinic populations, a third of BN patients take a chronic course.

Despite heightened public awareness of the burden of eating disorders, their prevalence has not declined. The major argument of this chapter is that

Early Detection and Management of Mental Disorders.

Edited by Mario Maj, Juan Jose? Lopez-Ibor, Norman Sartorius, Mitsumoto Sato and Ahmed Okasha. ©2005 John Wiley & Sons Ltd. ISBN 0-470-01083-5.

knowledge about precursors or ''forerunners'', which may constitute risk factors in the causal chain of events, provides an opportunity to identify vulnerable populations. Furthermore, understanding the precursors and early manifestations of the eating disorders may lead to better informed and more effective preventive measures. Given the complexity of psychiatric disorders, identifying variables that place a population at risk may not only serve as guidance for preventive intervention, which can have tremendous psychological and economic benefits to the individual, to families and to society as a whole, but it may also provide cues to the aetiology of the disorder.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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