Editing Bulimia nervosa (section)

==Epidemiology==
[[File:Eating disorders world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.3|Deaths due to eating disorders per million persons in 2012 {{Div col|small=yes|colwidth=10em}}{{legend|#ffff20|0-0}}{{legend|#ff9a20|1-1}}{{legend|#e06815|2-2}}{{legend|#d85010|3-3}}{{legend|#d02010|4–25}}{{div col end}}]]
There is little data on the percentage of people with bulimia in general populations.<ref name="DSM5" /> Most studies conducted thus far have been on convenience samples from hospital patients, high school or university students; research on bulimia nervosa among ethnic minorities has also been limited.<ref>{{Cite journal |last1=Ruchkin |first1=Vladislav |last2=Isaksson |first2=Johan |last3=Schwab-Stone |first3=Mary |last4=Stickley |first4=Andrew |date=2021-10-21 |title=Prevalence and early risk factors for bulimia nervosa symptoms in inner-city youth: gender and ethnicity perspectives |journal=Journal of Eating Disorders |language=en |volume=9 |issue=1 |pages=136 |doi=10.1186/s40337-021-00479-5 |doi-access=free |issn=2050-2974 |pmc=8529812 |pmid=34674763}}</ref> Existing studies have yielded a wide range of results: between 0.1% and 1.4% of males, and between 0.3% and 9.4% of females.<ref name="makino">{{cite journal | vauthors = Makino M, Tsuboi K, Dennerstein L | title = Prevalence of eating disorders: a comparison of Western and non-Western countries | journal = MedGenMed | volume = 6 | issue = 3 | pages = 49 | date = September 2004 | pmid = 15520673 | pmc = 1435625}}</ref> Studies on time trends in the prevalence of bulimia nervosa have also yielded inconsistent results.<ref>{{cite journal | vauthors = Hay PJ, Mond J, Buttner P, Darby A | title = Eating disorder behaviors are increasing: findings from two sequential community surveys in South Australia | journal = PLOS ONE | volume = 3 | issue = 2 | pages = e1541 | date = February 2008 | pmid = 18253489 | pmc = 2212110 | doi = 10.1371/journal.pone.0001541 | veditors = Murthy RS | bibcode = 2008PLoSO...3.1541H | doi-access = free}}</ref> According to Gelder, Mayou and Geddes (2005) bulimia nervosa is prevalent between 1 and 2 percent of women aged 15–40 years. Bulimia nervosa occurs more frequently in developed countries<ref name="Psychiatry">{{cite book |first1=Michael Graham |last1=Gelder |first2=Richard |last2=Mayou |first3=John |last3=Geddes | name-list-style = vanc |year=2005 |title=Psychiatry |publisher=Oxford University Press |isbn=978-0-19-852863-0 |url-access=registration |url=https://archive.org/details/psychiatry0000geld}}{{page needed|date=August 2013}}</ref> and in cities, with one study finding that bulimia is five times more prevalent in cities than in rural areas.<ref>{{cite journal | vauthors = van Son GE, van Hoeken D, Bartelds AI, van Furth EF, Hoek HW | title = Urbanisation and the incidence of eating disorders | journal = The British Journal of Psychiatry | volume = 189 | issue = 6 | pages = 562–3 | date = December 2006 | pmid = 17139044 | doi = 10.1192/bjp.bp.106.021378 | doi-access = free}}</ref> There is a perception that bulimia is most prevalent amongst girls from middle-class families;<ref>{{cite web|title=Bulimia |url=http://finddoctorsonline.com/health-topic.aspx/bulimia |archive-url=https://archive.today/20120709083530/http://finddoctorsonline.com/health-topic.aspx/bulimia |url-status=dead |archive-date=2012-07-09 |work=finddoctorsonline.com}}</ref> however, in a 2009 study girls from families in the lowest income bracket studied were 153 percent more likely to be bulimic than girls from the highest income bracket.<ref>{{cite news|vauthors = Grohol J|title=Black Girls At Risk for Bulimia|url=http://psychcentral.com/news/2009/03/19/black-girls-at-risk-for-bulimia/4835.html|date=March 19, 2009|url-status=live|archive-url=https://web.archive.org/web/20120524041711/http://psychcentral.com/news/2009/03/19/black-girls-at-risk-for-bulimia/4835.html|archive-date=May 24, 2012}}</ref> According to a study conducted in 2022 by Silen et al., which conglomerated statistics using various methods such as SCID, MRFS, EDE, SSAGA, and EDDI, the US, Finland, Australia, and the Netherlands had an estimated 2.1%, 2.4%, 1.0%, and 0.8% prevalence of bulimia nervosa among females under 30 years of age.<ref>{{cite journal |doi=10.1097/YCO.0000000000000818 |title=Worldwide prevalence of DSM-5 eating disorders among young people |date=2022 |last1=Silén |first1=Yasmina |last2=Keski-Rahkonen |first2=Anna |journal=Current Opinion in Psychiatry |volume=35 |issue=6 |pages=362–371 |pmid=36125216}}</ref> This demonstrates the prevalence of bulimia nervosa in developed, Western, first-world countries, indicating an urgency in treating adolescent women. Additionally, these statistics may be misrepresentative of the true population affected with bulimia nervosa due to potential underreporting bias.

There are higher rates of [[eating disorder]]s in groups involved in activities which idealize a slim physique, such as dance,<ref name="Tölgyes" /> gymnastics, modeling, [[cheerleading]], running, acting, swimming, diving, rowing and [[figure skating]]. Bulimia is thought to be more prevalent among [[white Americans|whites]];<ref>{{cite journal | vauthors = Franko DL, Becker AE, Thomas JJ, Herzog DB | title = Cross-ethnic differences in eating disorder symptoms and related distress | journal = The International Journal of Eating Disorders | volume = 40 | issue = 2 | pages = 156–64 | date = March 2007 | pmid = 17080449 | doi = 10.1002/eat.20341}}</ref> however, a more recent study showed that African-American teenage girls were 50 percent more likely than white girls to exhibit bulimic behavior, including both binging and purging.<ref>{{cite web|last=McBride|first=Hugh| name-list-style = vanc |title=Study Reveals Stunning Prevalence of Bulimia Among African-American Girls|url=http://www.teen-eating-disorders.net/teen_eating_disorders/study-reveals-stunning-prevalence-of-bulimia-among-african-american-girls.php|archive-url=https://web.archive.org/web/20120210165357/http://www.teen-eating-disorders.net/teen_eating_disorders/study-reveals-stunning-prevalence-of-bulimia-among-african-american-girls.php|archive-date=February 10, 2012}}</ref>

{| class="wikitable" style="margin-left: auto; margin-right: auto; border: none;"
! Country
! Year
! Sample size and type
! colspan="2" | % affected
|-
| [[Portugal]] || 2006 || 2,028 high school students || || 0.3% female<ref>{{cite journal | vauthors = Machado PP, Machado BC, Gonçalves S, Hoek HW | title = The prevalence of eating disorders not otherwise specified | journal = The International Journal of Eating Disorders | volume = 40 | issue = 3 | pages = 212–7 | date = April 2007 | pmid = 17173324 | doi = 10.1002/eat.20358 | hdl-access = free | hdl = 1822/5722}}</ref>
|-
| [[Brazil]] || 2004 || 1,807 students (ages 7–19) || 0.8% male || 1.3% female<ref>{{cite journal | vauthors = Vilela JE, Lamounier JA, Dellaretti Filho MA, Barros Neto JR, Horta GM | title = [Eating disorders in school children] | language = pt | journal = Jornal de Pediatria | volume = 80 | issue = 1 | pages = 49–54 | year = 2004 | pmid = 14978549 | doi = 10.1590/S0021-75572004000100010 | trans-title = Eating disorders in school children | doi-access = free}}</ref>
|-
| Spain || 2004 || 2,509 female adolescents (ages 13–22) || || 1.4% female<ref>{{cite journal | vauthors = Lahortiga-Ramos F, De Irala-Estévez J, Cano-Prous A, Gual-García P, Martínez-González MA, Cervera-Enguix S | title = Incidence of eating disorders in Navarra (Spain) | journal = European Psychiatry | volume = 20 | issue = 2 | pages = 179–85 | date = March 2005 | pmid = 15797704 | doi = 10.1016/j.eurpsy.2004.07.008 | s2cid = 20615315}}</ref>
|-
| Hungary || 2003 || 580 [[Budapest]] residents || 0.4% male || 3.6% female<ref name="Tölgyes">{{cite journal | vauthors = Tölgyes T, Nemessury J | title = Epidemiological studies on adverse dieting behaviours and eating disorders among young people in Hungary | journal = Social Psychiatry and Psychiatric Epidemiology | volume = 39 | issue = 8 | pages = 647–54 | date = August 2004 | pmid = 15300375 | doi = 10.1007/s00127-004-0783-z | s2cid = 23275345}}</ref>
|-
| Australia || 1998 || 4,200 high school students || align="center" colspan="2" | 0.3% combined<ref>{{cite journal | vauthors = Hay P | title = The epidemiology of eating disorder behaviors: an Australian community-based survey | journal = The International Journal of Eating Disorders | volume = 23 | issue = 4 | pages = 371–82 | date = May 1998 | pmid = 9561427 | doi = 10.1002/(SICI)1098-108X(199805)23:4<371::AID-EAT4>3.0.CO;2-F}}</ref>
|-
| United States || 1996 || 1,152 college students || 0.2% male || 1.3% female<ref>{{cite journal | vauthors = Pemberton AR, Vernon SW, Lee ES | title = Prevalence and correlates of bulimia nervosa and bulimic behaviors in a racially diverse sample of undergraduate students in two universities in southeast Texas | journal = American Journal of Epidemiology | volume = 144 | issue = 5 | pages = 450–5 | date = September 1996 | pmid = 8781459 | doi = 10.1093/oxfordjournals.aje.a008950 | doi-access = free}}</ref>
|-
| Norway || 1995 || 19,067 psychiatric patients || 0.7% male || 7.3% female<ref>{{cite journal | vauthors = Götestam KG, Eriksen L, Hagen H | title = An epidemiological study of eating disorders in Norwegian psychiatric institutions | journal = The International Journal of Eating Disorders | volume = 18 | issue = 3 | pages = 263–8 | date = November 1995 | pmid = 8556022 | doi = 10.1002/1098-108X(199511)18:3<263::AID-EAT2260180308>3.0.CO;2-O}}</ref>
|-
| Canada || 1995 || 8,116 (random sample) || 0.1% male || 1.1% female<ref>{{cite journal | vauthors = Garfinkel PE, Lin E, Goering P, Spegg C, Goldbloom DS, Kennedy S, Kaplan AS, Woodside DB | display-authors = 6 | title = Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups | journal = The American Journal of Psychiatry | volume = 152 | issue = 7 | pages = 1052–8 | date = July 1995 | pmid = 7793442 | doi = 10.1176/ajp.152.7.1052}}</ref>
|-
| Japan || 1995 || 2,597 high school students || 0.7% male || 1.9% female<ref>{{cite journal | vauthors = Suzuki K, Takeda A, Matsushita S | title = Coprevalence of bulimia with alcohol abuse and smoking among Japanese male and female high school students | journal = Addiction | volume = 90 | issue = 7 | pages = 971–5 | date = July 1995 | pmid = 7663319 | doi = 10.1046/j.1360-0443.1995.90797110.x}}</ref>
|-
| United States || 1992 || 799 college students || 0.4% male || 5.1% female<ref>{{cite journal | vauthors = Heatherton TF, Nichols P, Mahamedi F, Keel P | title = Body weight, dieting, and eating disorder symptoms among college students, 1982 to 1992 | journal = The American Journal of Psychiatry | volume = 152 | issue = 11 | pages = 1623–9 | date = November 1995 | pmid = 7485625 | doi = 10.1176/ajp.152.11.1623}}</ref>
|}