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A general population sample of 100 primigravid women was studied prospectively to describe the changes in eating that occur in pregnancy with particular reference to cravings and aversions and the behavior and attitudes characteristic of clinical eating disorders. Assessment was by standardized interview. Dietary cravings and aversions were found to be common and largely confined to early pregnancy. Eating disorder features decreased in severity early in pregnancy but increased later on. Dietary cravings rarely resulted in episodes of overeating like those seen in patients with eating disorders. In this study of a general population sample, no evidence was found of a relationship between pregnancy outcome and the severity of eating disorder features prior to pregnancy.

Bulimia nervosa may be treated successfully without focusing directly on the patient's eating habits and attitudes to shape and weight. Cognitive behavior therapy and IPT achieved equivalent effects through the operation of apparently different mediating mechanisms. A further comparison of CBT and IPT is warranted. The behavioral version of CBT was markedly less effective than the full treatment.

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In a patient suffering from severe bulimia nervosa, cognitive behavioral treatment was complicated by acute water intoxication. Fluid intake was investigated further in 21 patients fulfilling diagnostic criteria for bulimia nervosa. Results suggest that (1) high fluid intake is common, and (2) there is a high prevalence of self‐reported nonspecific symptoms that would be liable to mask water intoxication were it to occur. These and other factors suggest that it is in the nature of bulimia nervosa that relevant symptoms may be disregarded by both the patient and the therapist. Water intoxication as a life‐threatening aspect of bulimia nervosa and its treatment is discussed. Suggestions are made for the assessment of episodes of “binge drinking”.

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