title: Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients.
abstract: BACKGROUND
  Although psychiatric patients with eating disorders are known to be at risk for a variety of health problems, relatively little is known about eating disorders and associated health problems in other populations. An epidemiological study was conducted to investigate health problems and impairment associated with bulimia nervosa (BN) and binge eating disorder (BED) among female primary care and obstetric gynaecology patients.
  
  
  METHODS
  Psychiatric disorders, physical illnesses, disabilities, functional status and stress were assessed among 4651 female patients (age range:18 to 99 years) at 8 primary care and 7 obstetric gynaecology clinics throughout the United States.
  
  
  RESULTS
  Two hundred eighty-nine women (62%) were diagnosed with BN or BED. The prevalence of BN was approximately 1% among young and middle-aged women. The prevalence of BED increased steadily from early (3.3%) through middle (8.5%) adulthood. Anxiety disorders, mood disorders and diabetes were much more common among women with BN or BED than among women without these eating disorders. Women with BN or BED reported markedly poorer functioning and much higher levels of disability, health problems, insomnia, psychosocial stress and suicidal thoughts than did women without BN or BED, after co-occurring psychiatric disorders were controlled statistically. Yet, fewer than one of ten cases of BN or BED was recognized by the patients' physicians.
  
  
  CONCLUSIONS
  Patients with BN or BED often experience considerable disability, impairment, distress and co-occurring illnesses. Increased recognition of eating disorders may be a crucial step towards encouraging more patients to seek treatment for these disabling conditions.
authors.affiliation: Colombia University and the New York State Psychiatric Institute, New York 10032, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Johnson
authors.forename: R L
authors.initials: RL
authors.lastname: Spitzer
authors.forename: J B
authors.initials: JB
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006176:Gynecology; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D009774:Obstetrics; D015995:Prevalence; D011320:Primary Health Care; D011361:Professional Competence; D012720:Severity of Illness Index