The significance of a prior history of anorexia in bulimia nervosa

• Published in: The International journal of eating disorders Vol. 20; no. 3; pp. 253 - 261
• Main Authors: Sullivan, Patrick F., Bulik, Cynthia M., Carter, Frances A., Gendall, Kelly A., Joyce, Peter R.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.11.1996; Wiley; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Anorexia; Anorexia Nervosa - complications; Anxiety Disorders - complications; Biological and medical sciences; Body Weight; Bulimia; Bulimia - epidemiology; Eating behavior disorders; Eating disorders; Feeding Behavior; Female; Humans; Medical sciences; Middle Aged; Mood Disorders - complications; Personality Disorders - complications; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Women; Bulimia; Human; Female; Anorexia nervosa; Eating disorder; Antecedent
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/(SICI)1098-108X(199611)20:3<253::AID-EAT4>3.0.CO;2-N

Objective Some authors stratify women with current, normal‐weight bulimia nervosa into groups defined by the presence or absence of a past history of anorexia nervosa. Unlike the distinction between current anorexia nervosa with or without bulimic symptoms, fewer studies have investigated the significance of stratifying bulimic women by a past history of anorexia. Method: One hundred and fourteen women with bulimia nervosa in a clinical trial were studied via structured clinical interviews covering Axis I and II disorders and measures of personality and symptomatology. Prospective, 14‐day dietary analysis was available for a subset of subjects. Results: Bulimic women with a past history of anorexia nervosa were significantly more likely to have a lifetime anxiety disorder, lower current body mass index, increased cooperativeness on the Temperament and Character Inventory, and increased mature and neurotic scores on the Defense Style Questionnaire. These women also reported lower scores on the bulimia subscale of the Eating Disorders Inventory, but these self‐report data were not consistent with the numbers of objective binges or reported energy intake. The prevalence of other Axis I disorders, Axis II personality disorders, and bulimic symptomatology was quite similar across groups. Conclusions: Although bulimic women with a prior history of anorexia nervosa differed in limited respects from those without such a history, the differences were outweighed by the similarities. A past history of anorexia nervosa did not appear to define particularly meaningful subgroups of women with current, normal‐weight bulimia nervosa. © 1996 by John Wiley & Sons, Inc.