title: Importance of multiple purging methods in the classification of eating disorder subtypes.
abstract: OBJECTIVE
  To examine two assumptions implicit in the subtyping of eating disorders: (1) purging behaviors are interchangeable, and (2) a primary distinction exists between the presence vs. absence of any means of purging.
  
  
  METHODS
  Data from a longitudinal study of health and eating patterns were used to compare women who reported self-induced vomiting, laxative abuse, or their combination. Further comparisons were made among women who used multiple purging methods (MP), a single purging method (SP), and randomly selected controls who never purged.
  
  
  RESULTS
  Vomiting and laxative abuse were associated with similar levels of eating pathology whereas their combination was associated with greater eating pathology. MP women reported significantly greater eating pathology compared to SP women who reported significantly greater eating pathology compared to controls. Differences were maintained at 10-year follow-up.
  
  
  CONCLUSIONS
  Purging behaviors may be interchangeable but the use of multiple purging methods is associated with greater severity over time.
authors.affiliation: Department of Psychology, The University of Iowa, Iowa City, Iowa 52242, USA.
authors.forename: Alissa A
authors.initials: AA
authors.lastname: Haedt
authors.forename: Crystal
authors.initials: C
authors.lastname: Edler
authors.forename: Todd F
authors.initials: TF
authors.lastname: Heatherton
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Keel
mesh_terms: D000328:Adult; D001828:Body Image; D052018:Bulimia Nervosa / Q000145:classification* / Q000453:epidemiology*; D002400:Cathartics / Q000008:administration & dosage; D004232:Diuretics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015994:Incidence; D012928:Social Desirability; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000453:epidemiology
chemical_list: D002400:Cathartics; D004232:Diuretics