Bulimia nervosa: a four- to six-year follow-up study.

A consecutive series of 45 female bulimic patients treated by one of us was followed four to six years after termination of treatment. Thirty-five (78%) were successfully followed, six refused to participate in the study and four were untraced. At least seven (16%) had diagnosable bulimia nervosa at follow-up, and at least another seven had a subclinical form of the disorder during the six months prior to follow-up. Relapse into anorexia nervosa was uncommon, and the severity of the bulimic features had improved even among those still diagnosable as having the disorder. Affective disturbances were common among those who were bulimic. The findings were discussed in terms of the intermediate term outcome of the disorder and its identity as a clinical entity.