Depending on the population studied, between 2 percent and 1 percent of teenage females have had anorexia. Bulimia is more common. Estimates range from upward of 1 percent of adolescent and young adult females in the general population to 4 percent of female college students.
Typically, anorexia strikes between the ages of fourteen and eighteen; most of my patients range between ages twelve and thirty-five. Yet anyone, from a small child to a postmenopausal woman, can become a self-starver. In these cases a metabolic problem other than anorexia may be present. The onset of bulimia usually occurs later in life than anorexia: The average age is around sixteen to twenty.
Statistics can give us some idea of how widespread these illnesses are, but there are problems with the accuracy of these numbers.
For one thing the criteria doctors use to diagnose eating disorders keep changing. As these guidelines narrow, the number of people who fit them changes. People with milder cases may be grouped with severe cases and thus distort the picture. Also, the incidence among certain groups of people is changing. True, many eating-disordered people fit the stereotype of the white, upper-class teenager, but a growing number of patients do not match this description. The disorders are now more equally distributed among social classes-evidence that cultural pressure to be thin permeates all levels of society.
Over the last decade, there has been greater public awareness about eating disorders. There may simply be more victims. Or perhaps the number is the same, but more people are seeking help, inspired by media coverage of these illnesses.
Another possibility is that the number of reported cases is lower than it should be. Many people think eating disorders, like other psychiatric illnesses, are shameful or embarrassing, not just to the victim but to the family as well. Some people with these problems, particularly men, may choose not to get help.
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