Changes in the presenting features of females with anorexia nervosa in northeast Scotland, 1965–1991

OBJECTIVE Rates of anorexia nervosa among females presenting to specialist services in northeast Scotland had increased significantly between 1965 and 1991. We sought to elucidate possible causes of this change. METHOD Hospital and primary care records were searched. Age, weight, and body mass index (BMI) were determined for 196 patients and duration of symptoms from onset to presentation was established in 190 cases. Changes in these parameters were investigated over the 27-year period of the study. RESULTS There was no significant change in duration of illness or in age at presentation. BMIs increased significantly, but this arose because patients decreased in height, not because they increased in weight. There was no increase in seriously underweight patients with BMIs of < or =15. DISCUSSION Anorexic females were not referred at an earlier stage of their illness, but primary care teams may be identifying and referring milder cases. Alternatively, the findings may reflect an increasing incidence of eating disorders coupled with changes in their presenting symptomatology.