Bulimia Nervosa is an eating disorder characterised by the recurrent binge eating of junk food, combined with self-induced vomiting, misuse of laxatives or extreme exercise (Wilson and Pike, 2001). Bulimia is 9 times more common in women than in men (Barker, 1993), and more prevalent in Western industrialised cultures (Nasser, 1986). It has been claimed that Bulimia Nervosa is a culture-bound syndrome (Keel and Klump, 2003); however recent evidence has suggested this is not completely true.
Eating disorders were previously thought to be isolated to achievement-oriented, upper and middle class individuals in Western countries. Pate, Pumariega and Hester (1991) suggested that these disorders may be increasing in other sectors of society and in a number of diverse cultural settings. Eating disorders are, in fact, more prevalent within various cultural groups than previously recognized, both within American ethnic minorities and those in other countries. According to Nasser (1997, as cited in Gleitman, Gross and Reisberg, 2011), as cultures become more westernized, rates of bulimia nervosa increase.
However, there is also conflicting evidence. Davis, Clance and Gailis (1999) studied women living Canada, America, Africa and the Caribbean and took into account socio-cultural factors such as oppression, sexism and racism. They concluded that perceptions of body image change between African-American women and Caucasian women, with African- Americans having more body confidence and higher self-esteem.
Bulimia is believed to be confined to women only, however recently Psychologists have also been interested in the increase of bulimia in gay and bisexual men. Feldman and Meyer (2007) estimate that 15% of gay or bisexual men have at some time suffered from bulimia, compared with less than 10% of lesbians and 8% of heterosexual women. It is not clear why some gay men suffer from eating disorders; one reason may be that they have similar views to women towards body image and physical appearance, the ideal of which is promoted in the gay community.
Another belief is that bulimia is restricted to adolescent girls and young women, yet recent research suggests that is not entirely the case. Mangweth-Matzek et al (2006) suggest that body dissatisfaction continues into old age. 475 60-70 year old women were analysed, out of this sample 3.8% met the diagnostic criteria for bulimia. Although this is a small percentage, it shows that eating disorders are not just confined to young women.
In conclusion, evidence suggests that bulimia nervosa is more a characteristic of Western cultures, where women have a preoccupation with thinness (American Psychiatric Association, 2000). Research also suggests that within these Western cultures it is not just women who are suffering, but also gay and bisexual men. It would be wrong to assume that only adolescent and young females are bulimic, as studies have shown that the disorder carries on into later life.
American Psychiatric Association (2000). Practice guideline for the treatment of patients with eating disorders (2nd Edn). Washington, DC: American Psychiatric Association.
Barker, S.E. (1993) Journal of Abnormal Psychology, Volume 102(1), Pages 173-176, US: American Psychological Association, February 1993. DOI: 10.1037/0021-843X.102.1.173
Davis, N.L., Clance, P.R., Gailis, A.T. (1999) Psychotherapy: Theory, Research, Practice, Training, Volume 36(1), Pages 27-35, US: Division of Psychotherapy (29), American Psychological Association, 1999. DOI: 10.1037/h0087643
Feldman, M.B., Meyer, I.H. (January 2007) Eating Disorders in diverse lesbian, gay and bisexual populations, International Journal of Eating Disorders, Volume 40, Issue 3, Pages 218-226. DOI: 10.1002/eat.20360
Gleitman, H., Gross, J., Reisberg, D. (2011) Psychology Eighth Edition, Chapter 16, Pages 669-670. Norton & Company, Inc., 500 Fifth Avenue, New York, NY, 2011.
Keel, P.K., Klump, K.L. (2003) Psychology Bulletin, Volume 129(5), Pages 747-769, US: American Psychological Association, September, 2003. DOI: 10.1037/0033-2909.129.5.747
Mangweth-Matzek, B. (2006) Never too old for eating disorders or body dissatisfaction: A community study of elderly women, International Journal of Eating Disorders, Volume 39, Issue 7, Pages 583-586, November 2006. DOI: 10.1002/eat.20327
Nasser, M. (1986), Psychological Medicine, 16, Pages 621-625, Cambridge University Press, 1986. DOI: 10.1017/S0033291700010370
Pate, J.E., Pumariega, A.J., Hester, C. (1992) Journal of the American Academy of Child & Adolescent Psychiatry, Volume 31, Issue 5, Pages 802-809. DOI:10.1097/00004583-199209000-00005
Pike, K.M., Wilson, G.T. (1994) Assessment of diagnostic features of bulimia nervosa: Interview versus self-report format, International Journal of Eating Disorders, Volume 16, Issue 1, Pages 75-81, Wiley Periodicals, Inc., A Wiley Company, 1994. DOI: 10.1002/1098-108X(199407)16:13.0.CO;2-E