Abstract

SUMMARY Bulimia nervosa (BN) is a detrimental persistent eating disorder that impacts millions of women, and imposes serious costs on the economy in terms of physical health, treatment costs, absence from work and reduced human capital accumulation. One important issue in treating BN is that it is often undiagnosed, especially among disadvantaged girls. The failures to diagnose BN occur, in part, because many cases of BN are unobservable to others, and asking girls about their bingeing and purging behaviour can be considered invasive. Using data on eating disorder behaviours from the National Heart, Lung, and Blood Institute Growth and Health Study, we show that information on a girl’s personality traits, along with information on her family’s socioeconomic status (SES), can be used to impute the unobservable BN behaviour. In particular, we find that personality traits are significant determinants of bulimic behaviour, even after controlling for SES. These results suggest a way to target those who are likely to suffer from BN based on identifiable personality traits. Given the costs involved in BN, and the number of individuals affected, our research suggests a practical direction for public health policy to reduce the number of undiagnosed cases.

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