© 2005 Elsevier Ltd. All rights reserved.

Episodes of ravenous overeating, referred to as compulsive eating or binge eating, have been recognized clinically since the 1950s. However, the disorder of bulimia nervosa was not formally described until 1979. This relatively recent recognition of the eating disorder has two important implications. First, the clinical picture and understanding of the psychopathology is changing with time. This has led both to a refinement in the diagnostic criteria used to characterize the disorder and to changes in reported prevalence. Second, the research base used to make judgments about development, prevalence, treatment, prognosis, and prevention is smaller than that for anorexia nervosa. Quite simply, there are still many unknowns in the area of bulimia nervosa.

This article focuses on the features used to make a diagnosis of bulimia nervosa, the psychopathology and developmental course of the disorder, and the groups at risk. Specific attention is paid to the nutritional consequences of bulimia nervosa and the ways in which dietary management is used in its treatment. Finally, long-term prognosis is considered.

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