Is bulimia nervosa a heterogeneous disorder? Lessons from the history of medicine

A minority of researchers have argued, against the weight of opinion, that the etiology of bulimia may ultimately be explained more simply, and this “minority position” is presented as an exercise that may help to bring into relief the facts and philosophies behind some of the current controversies regarding the nature of Bulimia nervosa.

Abstract

What causes bulimia nervosa? Most authorities would respond that this question cannot be answered simply, in that bulimia nervosa has a multifactorial etiology in which psychological, sociocultural, biological, and other factors combine in different ways in different individuals to produce the syndrome. In other words, it has seemed axiomatic to many of us that bulimia nervosa is far too complex and heterogeneous to permit a simple, reductionistic explanation. However, a minority of researchers have argued, against the weight of opinion, that the etiology of bulimia may ultimately be explained more simply. Notable among these individuals are Drs. Harrison Pope and James Hudson, who are well known for their research on eating disorders in recent years. Accordingly, we have asked Drs. Pope and Hudson to present this "minority position," as an exercise that may help to bring into relief the facts and philosophies behind some of the current controversies regarding the nature of bulimia nervosa. We are also pleased to present an equally thought-provoking counterpoint on the heterogeneity of bulimia authored by P. J. V. Beumont of the University of Sydney, well known for his distinguished record of scholarly research in this field.