Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months.

Attenders to four South London group general practices were screened using the Eating Attitudes Test (EAT), after which all high scorers and a random selection of low scorers were approached for interview. General practitioners (GPs) were given details on a random half of high-scoring patients with the aim of assessing intervention for revealed and hidden psychopathology. Twelve to 18 months later all high scorers on the EAT were followed up by post to measure change in behaviour and attitudes. Practice records were examined to determine the doctor's knowledge of the patient and any intervention that had occurred. It was found that 1.1% of women had bulimia nervosa and 2.8% a partial-syndrome eating disorder. No cases of anorexia nervosa were found. Cases of bulimia nervosa and partial syndromes were similar in being: mainly female, of higher social class, in the normal weight range but with considerable weight fluctuation in the past, more likely to have had a history of menstrual irregularity, and frequently psychologically troubled with more past psychiatric contact. Over the follow-up period there was some change along a spectrum of normal dieting to the full syndrome, although only one subject with bulimia nervosa recovered significantly. Although the GPs were unaware of the eating pathology and their intervention was minimal, most had documented their patients' psychological distress.