title: Relations of bulimic symptom frequency and intensity to psychosocial impairment and health care utilization: results from a community-recruited sample.
abstract: OBJECTIVE
  To determine the frequency and intensity of bulimic symptoms related to psychosocial impairment and health care utilization.
  
  
  METHODS
  Females (N = 1231, M age = 17.7, range 13-55) from four community-recruited samples varying in bulimic pathology completed the eating disorder examination, social adjustment scale, and health survey utilization scale.
  
  
  RESULTS
  Co-occurrence of binge eating and compensatory behaviors and solely compensatory behaviors >or=1 time/month were associated with elevations in psychosocial impairment. Co-occurrence of both binge eating and compensatory behaviors and solely compensatory behaviors >or=8 times/month were related to greater service utilization. Solely binge eating and duration of bulimic behaviors were unrelated to these functional outcomes. Overvaluation of body shape and weight showed significant linear relations to the functional outcomes.
  
  
  CONCLUSIONS
  Results suggest that current diagnostic thresholds for bulimia nervosa may be too high when considering functional impairment and service utilization and that different cut-points need to be considered for different bulimic symptoms.
authors.affiliation: Oregon Research Institute, Eugene, Oregon 97401, USA. sonja_spoor@hotmail.com
authors.forename: Sonja T P
authors.initials: ST
authors.lastname: Spoor
authors.forename: Eric
authors.initials: E
authors.lastname: Stice
authors.forename: Emily
authors.initials: E
authors.lastname: Burton
authors.forename: Cara
authors.initials: C
authors.lastname: Bohon
mesh_terms: D000293:Adolescent; D000328:Adult; D052018:Bulimia Nervosa / Q000453:epidemiology* / Q000628:therapy*; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007398:Interpersonal Relations; D008875:Middle Aged; D011584:Psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology