The naturalistic history of bulimia nervosa: Extraordinarily high rates of chronicity, relapse, recurrence, and psychosocial morbidity

This article extends our previous report on 30 women with bulimia nervosa by increasing the duration of follow-up to 35–42 months. We found surprisingly low rates of recovery and very high rates of chronicity, relapse, recurrence, and psychosocial morbidity. Almost one third of the subjects remained in the index episode 3 years after entry into the study. There was a 63% cumulative probability of relapse by 78 weeks after recovery. Fifty percent of subjects who recovered from the first prospective episode relapsed into another episode. Predictors of recovery included having less disturbed eating behaviors and self/body image at intake and having several good friends.