<P> Bulimia is more common among those who have a close relative with the condition . The percentage risk that is estimated to be due to genetics is between 30% and 80% . Other risk factors for the disease include psychological stress, cultural pressure to attain a certain body type, poor self - esteem, and obesity . Living in a culture that promotes dieting and having parents that worry about weight are also risks . Diagnosis is based on a person's medical history, however this is difficult as people are usually secretive about their binge eating and purging habits . Furthermore, the diagnosis of anorexia nervosa takes precedence over that of bulimia . Other similar disorders include binge eating disorder, Kleine - Levin syndrome, and borderline personality disorder . </P> <P> Cognitive behavioral therapy is the primary treatment for bulimia . Antidepressants of the selective serotonin reuptake inhibitors (SSRI) or tricyclic antidepressant class may have a modest benefit . While outcomes with bulimia are typically better than in those of anorexia, the risk of death among those affected is higher than that of the general population . At 10 years after receiving treatment about 50% of people are fully recovered . </P> <P> Globally, bulimia was estimated to affect 3.6 million people in 2015 . About 1% of young women have bulimia at a given point in time and about 2% to 3% of women have the condition at some point in their lives . The condition is less common in the developing world . Bulimia is about nine times more likely to occur in women than men . Among women, rates are highest in young adults . Bulimia was named and first described by the British psychiatrist Gerald Russell in 1979 . </P> <P> Bulimia typically involves rapid and out - of - control eating, which may stop when the bulimic is interrupted by another person or the stomach hurts from over-extension, followed by self - induced vomiting or other forms of purging . This cycle may be repeated several times a week or, in more serious cases, several times a day and may directly cause: </P>

When was bulimia first recognised as an eating disorder