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Our third cross-sectional survey designed to elicit DSM-III inclusion criteria for bulimia was completed by 1836 students, 97.2% of those surveyed. Based on operationalized criteria, 4.7% of females reported a current eating disorder diagnosis. These included bulimia (4.3%), bulimia nervosa (2.2%), bulimia with weekly binge/purging behavior (1.1%), and anorexia nervosa (0.1%). Current bulimia was reported by 0.1% of males and current bulimia nervosa by 0.3%. Those women with current bulimia were more likely to report a history of treatment for alcoholism and drug abuse than those bulimic women in remission. The data suggest that fear of loss of control over eating is an important part of the diagnostic criteria for bulimia nervosa, while fear of being fat is less apt to differentiate between bulimic and nonbulimic women. The desire for low weight was more pronounced in bulimic female students in the current survey than in previous surveys. The percentage of women who reported a history of bulimia with weekly binge eating and purging went from 1% in 1980 to 3.2% in 1983 and to 2.2% in the current survey indicating that the prevalence for this disorder may have peaked and may be declining.

This paper reports the results of a questionnaire survey administered to 1355 college freshman (98.3% response rate) and to a comparison group of 37 female bulimic patients. Questions were contructed to elicit information which would allow identification of those respondents who would meet DSM-III requirements for diagnosis of bulimia. 2.1% of the student population (4.5% of females, 0.4% of males) met these modified criteria and the additional criterion of weekly binge-eating. The identified “bulimic” female students differed from female bulimic patients in their use of fasting instead of self-induced vomiting for weight control, and in their tendency to be overweight. “Bulimic” female students are also compared with nonbulimic students.

A self-report questionnaire designed to elicit the DSM-III inclusion criteria for bulimia was completed by 1389 students (95.9% of those surveyed) from the same geographic area surveyed 3 years previously. Approximately 8% of the female students endorsed the criteria for bulimia in each survey. Even with the more stringent criteria used in the current survey, the percentage of female students who reported all the operationalized criteria for bulimia and in addition engaged in weekly binge-purging behavior increased from 1% in 1980 to 3.2% in 1983. The female college students reporting bulimia in the current survey more closely resembled the bulimic patients coming for treatment than those in the previous survey, particularly in the reported frequency of daily binge eating, self-induced vomiting for weight control, and the endorsement of DSM-III Criterion B behaviors. Validation studies indicated that self-report questionnaires may not correctly identify binge eating, fear of loss of control over eating behaviors, or self-deprecatory thoughts after binge eating, when compared with professional assessment by interview.