Detecting and Treating Bulimia Nervosa: How Involved Are Family Physicians?

Abstract

Background: Relatively little is known about bulimia nervosa in the primary care setting. Existing medical literature suggests that primary care physicians have limited experience with bulimia nervosa.

Methods: Experiences of family physicians with bulimia nervosa specifically and eating disorders in general were assessed by a questionnaire mailed to a representative sample (596 subjects) of Ohio family physicians. The response rate was 52.6 percent.

Results: Approximately 30 percent of the respondents had never diagnosed bulimia in a patient; 60 percent had no bulimic patients at the time of the survey. The mean career total of bulimic patients per physician was 5.3 (SD = 5.6). Younger physicians and female physicians were more likely to have bulimic patients. Having bulimic patients correlated significantly with having contact with bulimic and with anorexic persons in nonoffice settings.

Conclusions: Despite a general prevalence rate of about 1 percent for bulimia (much greater for the female population, particularly in adolescents and athletes), nearly one third of Ohio family physicians have never diagnosed bulimia in a patient, and nearly two thirds are not currently providing care for bulimic patients. Because screening is quick, inexpensive, and straightforward, all at-risk patients—athletes or those who have concerns related to paucity of menstruation, gastrointestinal symptoms, dieting or weight concerns, and depression—should be screened for bulimia.