Bulimia Nervosa Epidemiology

Key Highlights

• Bulimia nervosa is a serious eating disorder marked by recurrent binge eating and compensatory behaviors, often beginning in adolescence or early adulthood. It can cause severe psychological distress and medical complications across multiple body systems.
• Our secondary analysis estimates that in the US, bulimia nervosa affects approximately 0.1% of the population.
• In Italy, bulimia nervosa affects an estimated around 5% of females, reflecting a substantial burden that underscores the need for greater recognition of its impact on women’s mental and physical health.
• In Japan, bulimia nervosa prevalence among females is around 1.02 per 100,000, highlighting its presence as a notable yet often under-recognized mental health concern in the population.
• Despite growing awareness, there is a significant unmet need for comprehensive and timely epidemiological data on bulimia nervosa. Its frequent symptom overlap and diagnostic confusion with other eating disorders lead to under recognition and misclassification, limiting accurate burden assessment and hindering targeted public health strategies.
• Despite advances in clinical understanding, timely and accurate diagnosis of bulimia nervosa remains a major challenge. Stigma and its frequent overlap with other mental health conditions often lead to delayed recognition, limiting early intervention and heightening the risk of long-term complications.

DelveInsight’s “Bulimia Nervosa – Epidemiology Forecast – 2034” report delivers an in-depth understanding of bulimia nervosa, historical and forecasted epidemiology trends in the United States, EU4 (Germany, France, Italy, Spain), the United Kingdom, and Japan. 

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2020–2034

Disease Understanding

Bulimia Nervosa Overview

Bulimia nervosa is a serious eating disorder characterized by recurrent episodes of excessive food intake followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, excessive exercise, or fasting. These behaviors stem from an intense preoccupation with body weight and shape, often driven by distorted self-image and heightened self-evaluation based on appearance. The disorder can develop gradually or present suddenly, frequently triggered by dieting, body dissatisfaction, or psychosocial stressors.

Bulimia nervosa commonly presents with binge eating, feelings of loss of control during episodes, and subsequent guilt or shame. Physical signs may include dental enamel erosion, gastrointestinal discomfort, electrolyte imbalances, and swelling of salivary glands. In more severe or prolonged cases, it can lead to serious complications such as cardiac arrhythmias, gastrointestinal injury, endocrine disturbances, or long-term psychological distress.

Bulimia Nervosa Diagnosis

The diagnosis of bulimia nervosa is primarily based on clinical evaluation and patient history rather than laboratory or imaging studies, with key indicators including recurrent binge eating episodes, inappropriate compensatory behaviors, and excessive preoccupation with body shape and weight. Symptoms often develop gradually, with early signs such as secretive eating, fluctuations in weight, and gastrointestinal discomfort commonly reported. In more severe or chronic cases, patients may present with medical complications such as electrolyte imbalances, dental erosion, or endocrine disturbances.

Severity is assessed through the frequency of binge-purge episodes, psychological impact, and the presence of physical complications. If not identified and addressed promptly, bulimia nervosa can lead to serious consequences, including cardiac arrhythmias, severe metabolic disturbances, gastrointestinal injury, and long-term psychiatric morbidity.

Further details related to disease understanding are provided in the report…

Bulimia Nervosa Epidemiology

The bulimia nervosa epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total prevalent cases of bulimia nervosa, total diagnosed prevalent cases of bulimia nervosa, gender–specific diagnosed prevalent cases of bulimia nervosa, age–specific diagnosed prevalent cases of bulimia nervosa and treated cases of bulimia nervosa in the 7MM covering, the United States, EU4 countries (Germany, France, Italy, and Spain), United Kingdom, and Japan from 2020 to 2034. 

• According to secondary analysis, in the US, bulimia nervosa affects an estimated 0.1% of the total male population and 0.5% of the total female population. Although the disorder occurs in both genders, it is more commonly diagnosed in females, with prevalence five times higher in females compared to males, highlighting the need for gender-responsive screening and intervention strategies.
• In Spain, the prevalence of bulimia nervosa is 0.53%, with cases occurring across all age groups, highlighting the need for sustained awareness and proactive identification to reduce long-term health and psychosocial consequences.
• In the UK, bulimia nervosa prevalence among females is estimated at 1% for ages 11–34, 1.05% for ages 35–44 and 45–59, and 0.26% for those 60 and over. Among males, prevalence is 0.33% for ages 11–34, 0.34% for ages 35–44 and 45–59, and 0.09% for those 60 and over, reflecting notable variation by both age and gender and underscoring the value of targeted awareness and early intervention strategies.
• A key unmet need in bulimia nervosa epidemiology is the lack of standardized data collection methods across regions and populations. Inconsistent diagnostic criteria, varying survey tools, and underreporting in certain healthcare settings limit the ability to generate reliable, comparable data, hindering accurate trend analysis and effective policy planning.

KOL Views

DelveInsight’s analysts collaborated with over 50 key opinion leaders (KOLs), conducting in-depth interviews with more than 15 experts across the 7MM. To keep pace with dynamic epidemiology trends, the team gathered first-hand insights from KOLs and subject matter experts (SMEs) through primary research, addressing data limitations and reinforcing findings from secondary research. These professionals offered valuable input on the bulimia nervosa landscape and highlighting patient behavior trends. Contributors included experts from renowned institutions such as the University of Rochester, US; Ruhr University Bochum, Germany; Rouen University Hospital, France; Hospital, Siracusa, Italy; Catholic University of Valencia San Vicente Mártir, Spain; University of Birmingham, the UK; Tokyo Dental College, Japan and Kanazawa Gakuin University, Japan; among others.

As per KOLs from the US, “A substantial proportion of bulimia nervosa cases remain unrecognized, particularly in individuals who do not fit common stereotypes of the disorder. Researchers note that its psychological and behavioral signs are often hidden or mistaken for other conditions, leading to delays in identification and increasing the risk of long-term health consequences. This diagnostic gap underscores the importance of enhancing clinical vigilance and refining assessment approaches to better capture the true burden of the disorder.”

KOLs from the UK, “The delayed or missed diagnosis of bulimia nervosa remains a considerable challenge, particularly in populations where eating disorders are under-recognized. Many cases come to light only after significant physical or psychological complications have developed, reflecting the subtle and often concealed nature of the disorder’s early signs and the need for more consistent recognition in diverse clinical settings.”

KOLs from Japan, “The absence of robust, nationally coordinated surveillance systems for bulimia nervosa poses a significant challenge to understanding its true burden. Many cases, particularly those with atypical presentations or overlapping features with other mental health conditions, remain undetected in routine practice. Researchers emphasize the need for more systematic data collection, improved interprofessional communication, and consistent reporting to capture accurate prevalence patterns and inform public health strategies.”

Scope of the Report

• The report covers a segment of executive summary, descriptive overview of bulimia nervosa, explaining its causes, signs and symptoms, and currently available diagnostic algorithms and guidelines.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and diagnosis guidelines.
• The report provides an edge for understanding trends, expert insights/KOL views, and patient journeys in the 7MM.
• A detailed review of current challenges in establishing the diagnosis.

Bulimia Nervosa Report Insights

• Patient Population
• Country-Wise Epidemiology Distribution
• Total Prevalent Cases of Bulimia Nervosa
• Total Diagnosed Prevalent Cases of Bulimia Nervosa
• Gender–specific Diagnosed Prevalent Cases of Bulimia Nervosa 
• Age–specific Diagnosed Prevalent Cases of Bulimia Nervosa 
• Treated Cases of Bulimia Nervosa

Bulimia Nervosa Report Key Strengths

• 10 years Forecast
• The 7MM Coverage 

Key Questions

Epidemiology Insights

• What are the disease risk, burden, and unmet needs of bulimia nervosa?
• What is the historical bulimia nervosa patient population in the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan?
• What would be the forecasted patient population of bulimia nervosa at the 7MM level?
• What will be the growth opportunities across the 7MM with respect to the patient population pertaining to bulimia nervosa?
• Out of the above-mentioned countries, which country would have the highest diagnosed prevalent cases of bulimia nervosa during the forecast period (2025–2034)?
• At what Compound annual growth rate (CAGR) the population is expected to grow across the 7MM during the forecast period (2025–2034)?

Reasons to Buy

• Insights on patient burden/disease prevalent, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To analyze epidemiological trends of bulimia nervosa across different regions and assess how these patterns may evolve in the coming years.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges.
• To understand the perspective of key opinion leaders around the current challenges with establishing the diagnosis options.

Frequently Asked Questions

1.What is the forecast period covered in the report?

• The bulimia nervosa epidemiology report for the 7MM covers the forecast period from 2025 to 2034, providing a projection of epidemiology dynamics and trends during this timeframe.

2.Out of all EU4 countries and the UK, which country had the highest diagnosed prevalent cases of bulimia nervosa cases?

• The highest cases of bulimia nervosa were found in Germany among EU4 and the UK.

3.How is epidemiological data collected and analyzed for forecasting purposes?

• Epidemiological data is collected through surveys, clinical studies, health records, and other sources. It is then analyzed to calculate disease rates, identify trends, and project future disease burdens using mathematical models.

4.Which age group accounts for the highest number of diagnosed prevalent cases of bulimia nervosa across the 7MM?

• The highest cases of bulimia nervosa across the 7MM were found in the 35–44 and 45–59 age groups.