Twenty-year follow-up of bulimia nervosa and related eating disorders not otherwise specified.

OBJECTIVE This study reports 20-year outcome of bulimia nervosa (BN) and related eating disorders not otherwise specified (EDNOS) and point prevalence of BN and EDNOS for a cohort of women and men in late adolescence (mean age = 20 ± 2 years), adulthood (30 ± 2 years), and mid-life (40 ± 2 years). METHOD N = 654 women and men, 73% of those assessed in 1982, completed 20-year follow-up in a two-stage design including questionnaires and structured clinical interviews. RESULTS Approximately 75% of women with BN were in remission at 20-year follow-up, and outcome did not differ significantly between BN and EDNOS. Eating disorder point prevalence declined in women but not men from late adolescence to mid-life. DISCUSSION Despite patterns of improvement in women, 4.5% reported a clinically significant eating disorder at mid-life, suggesting the need for more research on potential risk factors in this age group, such as pressures for women to maintain a youthful appearance.