There have been no extensive published
reports of childhood bulimia in association with purging.
The appearance of bulimia nervosa in latency may be
rare. Prepubertal children were thought to be insufficiently
sophisticated to purge; and latency-age girls were thought
to be less vulnerable to the social pressure to be thin.
However, Herzog, et al.  noted a ten-year-old male,
and Goodman  noted a fourteen-year-old female, each
hospitalized with an affective disturbance with both
binging and purging initiated in latency. Moreover,
Walsh  has identified adolescent female bulimics
who admitted to purging while in latency.
Two cases of bulimia and/or purging
(vomiting) beginning in latency are reported. One patient
had a severe affective disorder with lability and frequent
wrist cutting when seen as an adolescent. Two case reports
of male bulimia occurred in association with object
loss featuring global impulsiveness, learning disability,
and in one case, possible Attention Deficit Disorder
There may be a subgroup of mildly obese,
impulsive children (especially males) who have a variant
of bulimia. A complete evaluation, including the way
stressful events modify eating, the presence and frequency
of binging, fluctuations in weight, depression and delineation
of individual and family psychodynamics, is warranted
in obese children. Bulimia in latency, while probably
rare, does occur in atypical forms. Primary physicians
and school nurses need to recognize these symptoms and
carefully evaluate eating patterns of latency-age obese
and impulsive children.