Bulimia: Is It an Illness Entity?

A disturbance of eating may be symptomatic of other physical or psychiatric illness, for example the hypophagias associated with neoplastic disease or severe depression. In most instances of these secondary eating disorders there appears to be a true alteration in appetite, that is in the desire and relish for food. Primary eating disorders on the other hand are complex behavioral disturbances which do not result directly from changes in appetite. In this category are obesity, anorexia nervosa, and bulimia. The conditions of obesity and anorexia nervosa have been accepted for may years as clinical problems, and their history can be traced far back in the annals of medicine. The situation in regard to bulimia is rather different, since it has been recognized only recently as a subject of medical concern. The purpose of the present paper is to review the emergence of bulimia in the medical literature, discuss its status as a disorder, and advise caution before it is uncritically accepted as an illness entity. [ABSTRACT FROM AUTHOR]