Use of extreme weight control behaviors with and without binge eating in a community sample: implications for the classification of bulimic-type eating disorders.
OBJECTIVE
To inform the classification of bulimic-type eating disorders not meeting formal diagnostic criteria for bulimia nervosa (BN), levels of eating disorder psychopathology and functional impairment associated with subjective and objective bulimic episodes (SBEs and OBEs) and purging and nonpurging methods of weight control were examined in a large community-based sample of women (n = 5,232).


RESULTS
Participants who reported recurrent bulimic episodes had significantly higher levels of eating disorder psychopathology and functional impairment than those who did not and this was the case whether the episodes were objective or subjective. Similarly, participants who reported the use of extreme weight control behaviors had higher levels of eating disorder psychopathology and functional impairment than those who did not, and this was the case whether purging or nonpurging behaviors were employed. The combination of bulimic episodes and extreme weight control behaviors was associated with particularly high levels of eating disorder psychopathology and functional impairment.


CONCLUSIONS
The combination of bulimic episodes, objective or subjective, and extreme weight control behaviors, purging or nonpurging, is significant in terms of impairment in psychosocial functioning among individuals affected by eating disorders not meeting formal diagnostic criteria for BN. The combination of SBEs and extreme weight control behaviors, in particular, warrants further investigation.
Mond
Jonathan
J
Neuropsychiatric Research Institute, Fargo, North Dakota 58103, USA. jmond@nrifargo.com
Hay
Phillipa
P
Rodgers
Bryan
B
Owen
Cathy
C
Crosby
Ross
R
Mitchell
James
J
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D020958:Australian Capital Territory; D015992:Body Mass Index; D002032:Bulimia / Q000145:classification* / Q000175:diagnosis / Q000523:psychology; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D011581:Psychological Tests