Abstract
To study social patterning of overeating and symptoms of disordered eating in a general population. A representative, population-based cohort study. The Australian Longitudinal Study on Women's Health (ALSWH), Survey 1 in 1996 and Survey 2 in 2000. Women (n 12 599) aged 18-23 years completed a questionnaire survey at baseline, of whom 6866 could be studied prospectively. Seventeen per cent of women reported episodes of overeating, 16 % reported binge eating and 10 % reported compensatory behaviours. Almost 4 % of women reported symptoms consistent with bulimia nervosa. Low education, not living with family, perceived financial difficulty (OR=1·8 and 1·3 for women with severe and some financial difficulty, respectively, compared with none) and European language other than English spoken at home (OR=1·5 for European compared with Australian/English) were associated with higher prevalence of binge eating. Furthermore, longitudinal analyses indicated increased risk of persistent binge eating among women with a history of being overweight in childhood, those residing in metropolitan Australia, women with higher BMI, smokers and binge drinkers. Overeating, binge eating and symptoms of bulimia nervosa are common among young Australian women and cluster with binge drinking. Perceived financial stress appears to increase the risk of binge eating and bulimia nervosa. It is unclear whether women of European origin and those with a history of childhood overweight carry higher risk of binge eating because of genetic or cultural reasons.
Highlights
Exposures Own highest education (≤12 years or equivalent; trade/apprenticeship/certificate/ diploma; university/higher university degree), employment status, ability to manage on available income, area of residence[19], living situation, parity, language spoken at home and age at Survey 1 (18–23 years)
Compensatory measures for weight control were reported by 9·8 % of the women and 3·6 % of women reported symptoms consistent with bulimia nervosa (BN)
Limited by the design of our study, we find it difficult to speculate about reasons behind the apparently increased risk of binge eating and symptoms consistent with BN in young women from families recently emigrated from Europe in our study
Summary
The ALSWH[14] is a national longitudinal study of factors affecting the health and well-being of four cohorts of women who were born in 1921–26, 1946–51, 1973–78 and 1989–95. Exposures Own highest education (≤12 years or equivalent (e.g. higher school certificate); trade/apprenticeship/certificate/ diploma; university/higher university degree), employment status, ability to manage on available income (ranked on 5-point scale ranging from ‘It is impossible’ to ‘It is easy’), area of residence (classified according to the Australian Standard Geographic Classification for remoteness based on road distance to the closest service centre, which in turn is categorised on population size as: major cities of Australia; inner regional Australia; outer regional Australia; remote/very remote Australia)(19), living situation (partner/children; alone; parents/others; non-family), parity (no children; one child; two or more children), language spoken at home (derived variable based on responses to questions on country of birth and language: English Australian; English other; European; Asian/other) and age at Survey 1 (18–23 years). Statistical analyses were conducted using the statistical software packages SAS version 9.3 and STATA version 11
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