Rates of the eating disorder bulimia appear to have been
influenced by revelations Princess Diana had battled with the
condition, a study suggests.
Diana's bulimia was revealed in Andrew Morton's 1992
British Journal of Psychiatry research found rates
rose in the early 1990s - when news of Diana's illness appeared.
However, her death in 1997 coincided with the
beginning of the decline in the rate of bulimia seen by GPs.
But eating disorder experts said bulimia rates had
not fallen - instead fewer people were talking about it.
The Eating Disorders Association said the coverage of Diana's
illness, following revelations in Andrew Morton's 1992 book, had
raised awareness, and enabled people with bulimia to come forward.
Now, with less coverage of the condition, they
said a stigma had once again grown around bulimia, and people were
more likely to be suffering in silence.
A spokesman said people were more likely to hide
bulimia than anorexia because it involved binging and vomiting,
which people were unwilling to admit to doing.
Rates of anorexia remained stable during the
The study by London-based Institute of Psychiatry
experts found rates of anorexia remained stable over the same
The researchers screened the General Practice
Research Database for new cases of anorexia and bulimia nervosa for
females aged 10 to 39.
During the years 1988 to 1993 the incidence of
anorexia nervosa detected in primary care remained stable.
But rates of bulimia had more than doubled by the
In 1990, there were more than 25 cases of bulimia
per 100,000 women in the population aged 10 to 39, reaching a peak
of around 60 per 100,000 in 1996.
Since then, the rate of bulimia has declined.
Writing in the British Journal of Psychiatry, the
researchers led by Laura Currin, said: "Identification with a public
figure's struggle with bulimia might have temporarily decreased the
shame associated with the illness, and encouraged women to seek help
for the first time.
"This would suggest that some of the 1990s peak
might have been caused by the identification of long-standing cases
rather than a true increase in community incidence."
However, the researchers also suggested that
rising rates of bulimia may have been due to increased recognition
and detection efforts given to a new and "fashionable" diagnosis.
They call for detection and treatment efforts to
be aimed at young women aged 10 to19, as this is the group with the
highest risk of both anorexia and bulimia nervosa.
Steve Bloomfield, spokesman for the Eating
Disorders Association, told the BBC News Website: "We believe that
the incidence of bulimia hasn't changed.
"What's changed is the number of people who've
reported to their GP that there is a problem.
"Seeing people like Diana talking about their
illness does encourage people to come forward."
But he added: "Now, the symptoms and diagnosis are
not widely talked about.
"I think we are probably seeing more people
suffering in silence, who don't understand that they aren't the only
people with this problem."