Very early-onset bulimia nervosa: report of two cases.

Bulimia nervosa is very rare in children below the age of 14 years, and no reliable reports of prepubertal bulimia nervosa have been published. We describe two cases of early-onset bulimia nervosa who presented before the age of 14 years, and with premenarchal onset in one patient. Both girls demonstrated high levels of the risk factors known to play a part in the etiology of bulimia nervosa. Implications of these cases regarding the etiology and occurrence of bulimia nervosa in younger adolescents are discussed.