Covert eating disorders: The prevalence, characteristics and help-seeking of those with bulimic eating disorders in general practice

Bulimic-type eating disorders are often missed in primary care. The aims of this study were: (i) to assess the prevalence and better characterize such disorders in primary care, and (ii) to evaluate the help-seeking behaviour of sufferers. Five hundred adult women general practice attenders were screened by questionnaire. Subjects who met screening criteria, and a random sample of the remainder, were interviewed. Twenty-six subjects (5.2%) had an eating disorder, the majority of which were not identified. Their mean global Eating Disorder Examination score was 2.8 (SD 1.2). The most common diagnosis was 'eating disorder not otherwise specified' (EDNOS) in which the most common group was subjects whose 'binge eating episodes' lacked control, but were not objectively large (n = 13). Seven subjects had bulimia nervosa. Most had sought help for a perceived (over)weight problem. In primary care women with eating disorders are more likely to seek help for a problem with excess weight than for eating disorder symptoms. Better definition of EDNOS syndromes may help in their detection.