Thirty normal-weight female bulimics were followed up 2-5 years following hospital admission using semistructured interviews and psychometric measures. Inasmuch as bulimia was only recently designated a distinct disorder, questions have emerged with regard to its clinical course and diagnostic validity. Results of this investigation suggest that bulimia displays a chronic but tractable course in that the majority of the patients continued to report bulimic behaviors at follow-up but the symptom intensity was greatly reduced from admission. The characterization of three bulimic outcome groups suggests that the outcome pattern of this disorder is heterogeneous, with some patients becoming symptom-free and others remaining severely afflicted. The durability of the symptoms and the failure of new psychiatric syndromes to emerge in the follow-up period is evidence that bulimia is a distinct diagnostic entity and not a variant of another underlying condition. The methodologic limitations of this study are addressed.
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