Bulimia nervosa in adolescents: treatment, eating pathology and comorbidity

  • Daniel le Grange
  • James Lock


Background: Bulimia nervosa (BN) is occurring with increasing frequency among adolescents. Yet, few studies have undertaken to detail the clinical presentation, or investigate different treatments for adolescents with BN. Objective: In this article, we 1) review our current knowledge of BN in adolescents, both in terms of clinical presentation and treatment possibilities, and 2) describe a cohort of adolescent bulimics in terms of eating pathology and comorbidity.
Subjects: Twenty-seven consecutive referrals for adolescent BN to The University of Chicago Hospitals are presented here (mean age=16.2 yrs, sd+1.4). These patients are among the first to be evaluated for participation in an ongoing randomized controlled trial of two psychosocial treatments.
Measures: Eating pathology was measured with the Eating Disorders Examination (EDE), while the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) was used to establish comorbid psychiatric diagnoses.
Results: Our findings indicate that this cohort is quite diverse in terms of ethnicity and family environment. Rates of comorbid depression are much higher in our cohort than in a comparable sample of adult BN. In most other respects, the clinical presentation of BN in our sample of adolescents appears to be similar to that in adults.
Conclusion: Comorbidity and adolescent developmental status are two obvious factors that should be taken into account in the evaluation of effective treatments for adolescent BN.

South African Psychiatry Review - August 2002

Author Biographies

Daniel le Grange
Department of Psychiatry, The University of Chicago,Chicago,USA
James Lock
Department of Psychiatry and Behavioral Science, Stanford University School of Medicine,Stanford, CA,USA

Journal Identifiers

eISSN: 1994-8220