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This longitudinal survey study of 557 college women used the new Eating Pathology Scale to classify respondents as nondieters, casual dieters, intensive dieters, dieters at risk, and bulimic. Shifts in the severity of dieting behavior over a 6-month period occurred primarily between adjacent scale categories. While new cases of bulimia were drawn from intensive dieters and dieters at risk, those women who no longer met DSM-III-R criteria for bulimia nervosa continued to engage in bulimic behavior.

A patient whose symptoms suggested bulimia was found to have increased intracranial pressure. Following insertion of a ventriculo-peritoneal shunt, the bulimic symptoms resolved. The relationship between increased CSF pressure and bulimic symptoms is discussed.

In a longitudinal survey of college freshmen, the incidence of bulimia nervosa was 4.2 cases per 100 women per year. Prevalence remained stable (2.9%-3.3%) as new cases were offset by partial remissions. Some women continued bulimic behaviors without meeting the DSM-III-R criteria.