Urban living linked to higher rates of bulimia

LONDON, Dec 2 (Reuters) Living in big cities raises the risk of suffering from the eating disorder bulimia but not anorexia nervosa, Dutch psychologists said on Friday.

They found women in cities were five times more likely to have the binge-and-purge illness than those who live in villages and hamlets but that there was no difference in anorexia rates.

Although the research was done in the Netherlands, Gabriella van Son, of the Centre for Eating Disorders in Leidschendam believes the findings are relevant to other developed countries.

''Bulimia, which is closely related to anorexia nervosa, is more common in large cities when you compare it with rates in rural areas,'' she said in an interview.

''The number of newly diagnosed patients with bulimia is about five times higher in cities.'' Bulimia and anorexia affect mainly girls and women. Both are linked with an obsessive desire to be thin.

But while anorexics eat very little, bulimics binge and then force themselves to vomit or use laxatives and diuretics to purge food from their body.

Anorexia usually begins during the teen years and bulimia, which affects about one percent of women, can occur at the same time or later. Both can be treated with behavioural therapy and counselling.

''Bulimia is also more secretive than anorexia because people are ashamed of their behaviour. They try to avoid telling other people about it,'' said Van Son.

She and her colleagues, who reported their findings in the British Journal of Psychiatry, said they do not know why there is a difference in the incidence of bulimia between women in cities and rural areas.

''The reason for the association is speculative,'' she said.

They suggested it could be related to the anonymity of cities where it would be easier for a woman to conceal her bulimia and use of laxatives than in a small town.

Women may also have symptoms that are not detected until they are older and have moved to urban areas to continue their education and to further their careers.

The findings are based on a study of newly diagnosed cases of bulimia and anorexia by a network of 63 general practitioners between 1985-1989 and 1995-1999. The bulimia rate was 2.5 times higher in urban areas than in the countryside and five times higher in large cities.

Van Son said the findings provide a promising avenue for further research into the causes of bulimia and anorexia.

REUTERS SB ND0936