Bulimia, characterized by eating binges, self-induced vomiting, and overuse of laxatives, may be surprisingly common and subject to misdiagnosis by physicians unfamiliar with this disorder. That is the suggestion of University of Minnesota clinicians, who treated 70 patients with severe bulimia in the past year. Richard Pyle, MD, and colleagues say bulimia typically affects young, upwardly mobile women from upperor middle-class families who have an exaggerated fear of becoming obese and who usually have experienced a recent traumatic event. They estimate 2% to 4% of all first-year college women experience this disorder to some degree. Of 34 patients who were studied closely, all were white, female, young (median age, 24 years; median age at onset: 18 years), and had at least started college. None was overweight, and 30 had experienced recent trauma, usually loss of or separation from