Prevalence Of Bulimia Nervosa Research Articles

Prevalence and related factors of eating disorders in pregnancy: a systematic review and meta-analysis.

To reveal the prevalence of eating disorders (EDs) and related factors in pregnancy. The search was performed in PubMed, EBSCOhost, Web of Science, Scopus, Google Scholar, and Ovid databases search up to April 3, 2022, using the keywords combination of "(eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder) AND (pregnancy OR pregnant)". Two researchers independently extracted data from the articles using a standard form. We evaluated the quality of the studies according to the Joanna Briggs Institute assessment tools. The prevalence of EDs in pregnant women in the 11 studies involving 2,369,520 pregnant women was ranging between 0.5 and 10.6%. The prevalence of EDs in pregnant women was 4.3% (95% confidence interval 2%-9%; I2 = 99.5%). The prevalence of anorexia nervosa and binge eating disorder during pregnancy shows a statistically significant increase compared to pre-pregnancy, and the prevalence of bulimia nervosa during pregnancy decreases. The prevalence of EDs is higher in pregnant women under 30years of age, secondary school graduates, married, and with normal BMI. Half of the pregnant women with EDs had anxiety and about one-third of pregnant women had depression. Excessive exercise is observed in 0.7% of pregnant women, fasting in 0.3%, laxative or diuretic use in 0.1%, and self-induced vomiting in 0.6%. This study is important as it is the first systematic review and meta-analysis to reveal the global prevalence of EDs in pregnant women and related factors. Continuing routine screening tests to detect EDs during pregnancy may contribute to taking special preventive measures for risk groups and protecting mother-child health. PROSPERO registration number (CRD42022324721), date of registration: 10/05/2022.

The Prevalence of Preadolescent Eating Disorders in the United States

PurposeThe prevalence of eating disorders (EDs) in young children remains relatively unknown. Here, we aimed to assess the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), binge ED (BED), and their subclinical derivatives, among 10- to 11-year-old children in the United States. MethodsCross-sectional data from the year 1 sample of the nationwide Adolescent Cognitive Brain Development study were extracted, and unadjusted prevalence of EDs was reported, as per DSM-5 criteria. ResultsAmong 10- to 11-year-old children in the United States, no cases of AN were reported. The prevalence of BN was negligible, whereas the prevalence of BED was 1.1%. The prevalence of subclinical AN, BN, and BED was 6%, 0.2%, and 0.5%, respectively. DiscussionBED is the most prevalent ED subtype among preadolescent children in the United States, although subclinical markers for all ED subtypes are evident in this age range.

Prevalence and characteristics of eating disorders among college students of a nonmetro city of Gujarat.

Context:There is a relative paucity of prevalence data about eating disorders (EDs) in India among young population.Aims:We aimed to estimate the prevalence and characteristics of EDs and abnormal eating behaviors among college students of a nonmetro city of Gujarat.Setting and Design:A cross-sectional survey was done among five colleges of a nonmetro city in Gujarat from February to September 2019.Subjects and Methods:Total 790 college students were assessed using a semi-structured format, Eating Attitudes Test-26, and Bulimic Investigatory Test Edinburgh followed by structured clinical interview as per DSM-5 criteria for EDs.Statistical Analysis:Outcomes were expressed in frequency, proportion, mean, and standard deviation. P values were calculated by Pearson Chi-square test or Fisher's exact test to determine the significance of the result.Results:The prevalence of abnormal eating behaviors was 25.2% (n = 199). Anorexia nervosa (AN) was not detected. The prevalence of bulimia nervosa (BN) was 0.2% and other specified feeding or eating disorder (OSFED) was 0.6%. “Being aware of calorie content” (53.7%) and “preoccupation with desire of thinness” (46.3%) were commonly found. “Impulse to vomit after meals” (2.5%) was least common. Lower body mass index was found among subjects with abnormal eating behavior. None of the subjects had amenorrhea.Conclusions:The prevalence of disordered eating behaviors, BN, and OSFED was 25.2%, 0.2%, and 0.6%, respectively. AN was not detected. OSFED was the most common ED and the characteristic “body image disturbance” was the most common symptom.

PREVALENCE OF BULIMIA NERVOSA: A CROSS-SECTIONAL STUDY

Purpose: The study examines the prevalence of Bulimia nervosa in students at King Abdulaziz University in Saudi Arabia.Bulimia nervosaisan eating disorder characterized by consumption of large amounts of food by an individual followed by an attempt such as self-induced vomiting, long periods of exercising, and diuretics to avoid gaining weight. Patients and Method: The study adopted a cross-sectional survey among King Abdulaziz University students in Saudi Arabia. A sample of 499 comprising 357 females and 142 males was randomly selectedparticipants—the age of the sample population aged between 20 to over 55 years. The participants filled questionnaires about eating behavior, smoking, body image, and psychiatrist disorders. The height and weight of the sample population were taken, and their BMI was established. Results: Based on our statistics, the prevalence of bulimia nervosa among the male was 0.3%, and that of the female was 1.4%. Extra observation revealed that those with mild or severe disorders were equally susceptible to depression and mood swing problems. The prevalence of Bulimia nervosa based on ages showed 80/50000 at 10 -30 years and 145/50000 at 31 – 80 years. The clinically prescribed healing period was idealized to be one year. Conclusion:The results show a comparatively high rate of BN among young people aged between 20 and 25, as reflected among King Abdulaziz University students in Saudi Arabia. Therefore, there is a need to increase public awareness about BN and other eating disorders in Saudi Arabia.

Disparities in DSM‐5 defined eating disorders by sexual orientation among U.S. adults

The increased occurrence of disordered eating behaviors among sexual minorities is well established; however, few studies have examined disparities in eating disorder diagnoses among this population. This study sought to examine lifetime prevalence estimates of DSM-5 defined EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) as a function of sexual orientation. We then compared prevalence of EDs based on experiences with perceived discrimination. A nationally representative sample of U.S. adults (N = 35,995) participating in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III completed structured diagnostic interviews. Prevalence rates were significantly higher among sexual minorities than heterosexual respondents for all EDs: AN = 1.71% (SE = 0.50) versus 0.77% (SE = 0.07), BN = 1.25% (SE = 0.37) versus 0.24% (SE = 0.03), BED = 2.17% (SE = 0.52) versus 0.81% (SE = 0.05). Odds of lifetime diagnosis were significantly greater among sexual minorities for AN (adjusted odds ratio [AOR] = 1.93), BN (AOR = 3.69), and BED (AOR = 2.32), after adjusting for sociodemographic variables. Sexual minorities reporting experiences with perceived discrimination had significantly higher prevalence of AN than those not endorsing perceived discrimination: 3.78% (SE = 1.43) versus 0.82% (SE = 0.33); AOR = 5.06. There were no significant differences in prevalence of BN or BED by perceived discrimination. Findings indicate that sexual minorities are disproportionately affected by EDs. Further research is needed to better understand mechanisms contributing to these disparities and heightened risk for EDs.

Eating disorders in Malays in Singapore

IntroductionThe prevalence of eating disorders has been increasing in the Asian countries. Malays in Singapore are at the crossroads because they are largely traditional in practice and almost all are Muslim, but are exposed to western culture. Studies found that Malays at increased risk of eating disorders but yet those that present for treatment are very small, and this study aims to study Malays with eating disorders to unveil this contradiction.MethodsAll Malay patients presenting to Singapore General Hospital (SGH), which hosts the only specialized eating disorder programme in Singapore, between 2003 and 2014 were identified and medical records studied retrospectively.ResultsMalays constitute only 42 out of 1340 patients treated in the same period. The mean age at presentation is 18.81 years (SD = 5.54) and the majority are students (78.6%). A total of 92.9% are single. There are more cases of bulimia nervosa than anorexia nervosa (45.2% vs. 26.2%). In total, 54.8% have psychiatric comorbidities, the most common is depression (31.0%), 38.1% have a history of deliberate self-harm and 21.4% attempted suicide. A total of 52.4% reported teasing as a trigger, while 16.7% were triggered by being overweight.DiscussionThere is only a small number of Malays that presented. Fasting is commonly which may be confused with restriction. Other factors could be lack of awareness. The higher prevalence of bulimia nervosa suggests that purging is recognized as abnormal. High prevalence of comorbidities suggests that family members recognize comorbidities better. Outreach programs for Malay will help increase awareness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Increased risk of disordered eating in polycystic ovary syndrome

To determine the prevalence of eating disorders (EDs) in women with polycystic ovary syndrome (PCOS) and the effects of EDs on health-related quality of life. Cross-sectional study. University practice. Women with PCOS (Rotterdam criteria; n = 148) and controls seen for routine gynecologic care (n = 106) from 2015 to2016. Eating Disorder Examination-Questionnaire (EDE-Q), Night Eating Questionnaire (NEQ), Hospital Anxiety and Depression Scale, and Health-Related Quality of Life Questionnaire (PCOSQ). EDE-Q and NEQ scores, prevalence of bulimia nervosa (BN), binge eating disorder (BED), and night eating syndrome (NES). Women with PCOS were at an increased risk for overall abnormal EDE-Q scores compared with controls (12.16% vs. 2.83%; odds ratio [OR], 4.75; 95% confidence interval [CI], 1.36, 16.58). Clinically significant elevated scores were noted for shape and weight concern. In unadjusted analysis, body mass index (OR, 1.06; 95% CI, 1.01, 1.11), elevated depression score (OR, 5.43; 95% CI, 1.85, 15.88), and elevated anxiety score (OR, 6.60; 95% CI, 2.45, 17.76) were associated with an abnormal EDE-Q global score. In the multivariable model, PCOS was associated with abnormal EDE-Q global score (adjusted OR, 4.67; 95% CI, 1.16, 18.80). Elevated EDE-Q scores inversely correlated with PCOSQ scores (r = -0.57). The prevalence of BN was 6.1%, of BED was 17.6%, and of NES was 12.9% in women with PCOS, with no differences compared with controls. Women with PCOS, especially those with concurrent anxiety symptoms but independent of obesity, have a significantly increased risk of abnormal EDE-Q scores. Our findings suggest the need for routine screening for ED in this population.

Epidemiology of eating disorders in Latin America: a systematic review and meta-analysis.

Eating disorders are currently not considered to be limited to Western culture. We systematically reviewed the existing literature on the prevalence of eating disorders in Latin America. Of 1583 records screened, 17 studies from Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela were included in the analysis. Most studies reported point-prevalence rates and only three studies provided lifetime and 12-month prevalence rates. We found a mean point-prevalence rate of 0.1% for anorexia nervosa, 1.16% for bulimia nervosa, and 3.53% for binge-eating disorder (BED) in the general population. Heterogeneity for bulimia nervosa and BED was large. This meta-analysis indicates that the prevalence of anorexia nervosa seems to be lower, whereas the prevalence of bulimia nervosa and especially of BED seems to be higher in Latin America than in Western countries. Our findings show that eating disorders are common mental disorders in Latin America. However, some facets of Latin American culture might be protective for the development of anorexia nervosa and increase the risk for bulimia nervosa and BED. Further studies investigating the epidemiology of eating disorders and their relation to culture in Latin America are needed. SPANISH ABSTRACT.

Mexican American women’s perspectives on a culturally adapted cognitive-behavioral therapy guided self-help program for binge eating.

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)-a low-cost minimal intervention-has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Posttreatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: (a) eating behavior and body ideals are socially and culturally constructed, (b) multifaceted support system is crucial to Mexican American women's treatment engagement and success, and (c) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women's experience, but it can be strengthened with increased family and peer involvement. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings.

Association between Puberty, Bulimia Nervosa and Depression

Background: Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are diseases characterized by an eating disorder, distorted weight regulation and distorted perception of one’s body. In the period of puberty adolescents are becoming increasingly vulnerable to eating disorders. Objective: The target of this study was to examine the prevalence of possible eating disorder (bulimia nervosa) and depression in the period of puberty. Methods: The study group included 233 students from secondary schools, of whom 128 were boys and 105 girls, with an average mean age of 14 years. The Eating Attitude Test (EAT-26) and Children’s Depression Inventory (CDI) were applied to the entire study population. Also we calculate the Body Mass Index (BMI); a parameter defines as the ratio of human body weight and height. Results: According to the EAT, 73 (32%) students had a EAT score indicating a possible diagnosis of bulimia nervosa. The authors observed statistically significant increased frequency of depressive thoughts in the study group. 188 (81%) students had emotional symptoms of depression Correlation results indicated that depressed mood scores positively correlated with bulimia scores. Conclusions: We observed high prevalence of bulimia nervosa and depression in the period of puberty.Bangladesh Journal of Medical Science Vol.14(4) 2015 p.327-330

Eating Disorders May Pose Greater Risk in Type 1 Diabetes

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessEating Disorders May Pose Greater Risk in Type 1 DiabetesLeslie SinclairLeslie SinclairSearch for more papers by this authorPublished Online:25 Jun 2013https://doi.org/10.1176/appi.pn.2013.6b18AbstractClinicians must discern whether poor diabetic control is just that, or something more troubling in patients with type 1 diabetes.When treating patients with type 1 diabetes (DM-1), clinicians often focus on the potential for microvascular and macrovascular complications, such as retinopathy and cardiovascular disease. But many DM-1 patients are at much greater risk for a different complication: an eating disorder.DM-1 is among the most common chronic illnesses of childhood, with a prevalence of 0.1 percent in the general population, affecting both genders equally. “The highest risk for an eating disorder appears when patients are diagnosed with DM-1 between ages 7 and 18 years,” explained Erin Sterenson, M.D., a psychosomatic medicine fellow at the Mayo Clinic in Rochester, Minn., who led the Academy of Psychosomatic Medicine’s seminar “Eating Disorders Through the Lifespan” at APA’s 2013 annual meeting in San Francisco in May. Routine methods for monitoring and controlling blood glucose levels can be mistaken for signs of an eating disorder in DM-1 patients.Dmitry Lobanov/ShutterstockSterenson explained that although the prevalence of anorexia nervosa in DM-1 patients is thought to be equal to that in non-DM-1 patients—which she noted are between 0 percent and 3.2 percent—the prevalence of bulimia nervosa is much higher, up to 35 percent compared with 1 percent to 2 percent in the general population. DM-1 patients with disordered eating, informally known as diabulimia, have an unusual and potentially dangerous method for purging calories at their disposal: insulin restriction or omission. When insulin is underdosed in these patients, muscle and fat are broken down into ketone bodies, sugar is unable to enter cells and be used for energy, and sugar (calories) is purged via urination, resulting in weight loss. How common are eating disorders in DM-1 patients? Sterenson pointed out that studies suggest DM-1 patients are two to four times more likely to experience an eating disorder than are nondiabetics. Consistent with other forms of eating disorders, 95 percent of DM-1 patients with eating disorders are female, and 45 percent are aged 15 and 30. Rates of insulin omission also appear to peak between the ages of 15 and 30 in diabulimic patients. But detecting an eating disorder in a DM-1 patient can be challenging, Sterenson said. There are many legitimate reasons why DM-1 patients might restrict their insulin intake, such as simply forgetting to dose themselves. Fear of hypoglycemia and its social implications, uncertainty about carbohydrate counts, increased physical activity, and limited access to food or medical supplies in certain settings can also result in insulin restriction.Identifying DM-1 patients with eating disorders is made even more complicated by the lack of a validated screening tool. Tools designed for non-DM-1 patients can be misleading. “The general screening tools often ask questions that most of our patients with DM-1 are encouraged to incorporate into their daily life, such as being aware of calorie content and carbohydrate content,” said Sterenson. “On the other hand, these screening measures don’t evaluate patients for insulin omission or underdosing.” Normal aspects of management of DM-1 can also create risk factors for an eating disorder. Dietary restraint and preoccupation with food, disregard for hunger and satiety cues, perceived and actual loss of control and independence, and a focus on exercise are all aspects of daily management of DM-1, as well as potential triggers for an eating disorder. But there are signs and symptoms that should raise a clinician’s “index of suspicion” for an eating disorder in a DM-1 patient, Sterenson emphasized, including extreme concerns about body shape or weight, intense exercise regimens, and low-calorie meal plans. Unexplained elevations in HbA1c, repeated episodes of diabetic ketoacidosis, and resistance to treating hypoglycemia should also be investigated. And while detection of an eating disorder in a DM-1 patient can be tricky, treatment and prevention are even more complicated, she noted. Psychotherapy, assessment and treatment of psychiatric comorbidities, and less-intensive dietary management are some appropriate approaches, but little information about the effectiveness of any specific treatment is available, and Sterenson stressed the need for greater focus on evaluating and treating diabulimic patients. “For many DM-1 patients, eating disorders present a much greater risk than the microvascular and macrovascular complications on which we so often focus,” she said. ■To watch a video interview of Sterenson, go to http://www.youtube.com/watch?v=eAW5wqDxeyE. ISSUES NewArchived

Personality subtypes in male patients with eating disorder: validation of a classification approach

In the present study, we investigated personality subtypes and their correlates in a sample of 132 male patients with eating disorder (ED). All patients filled out the Temperament and Character Inventory-Revised, the Eating Disorder Inventory-2, and the Symptom Checklist-90-Revised. Three personality subtypes emerged. Cluster 1, the adaptive-like subtype, was characterized by a high prevalence of eating-disorder-not-otherwise-specified and low levels of ED and general psychopathology. Cluster 2, the average or socially detached subtype, showed a high prevalence of eating-disorder-not-otherwise-specified, more social problems, less motivation for treatment, and an intermediate position on the psychopathology dimension between patients of clusters 1 and 3. Finally, cluster 3, the maladaptive subtype, was characterized the highest prevalence of bulimia nervosa and the highest scores on ED and general psychopathology. Our data support the presence of the 3 personality subtypes in male patients with ED. Future studies need to address whether patients of different subtypes differ with respect to therapy outcome.

High prevalence of bulimia nervosa in lupic patients

Conclusions An alarming high incidence of bulimia nervosa was found in this sample and this may indicate lupic patients are susceptible to eating disorders, considering their exposition to steroids and other medications related to weight gain. More studies are necessary in order to confirm such data. Author details Departament of Neuropsychiatry, UFPE/Hospital das Clinicas, Recife, Pernambuco, Brazil. Departament of Rheumatology, UFPE/Hospital das Clinicas, Recife, Pernambuco, Brazil.

Hormonal Alteration in Obese Adolescents with Eating Disorder: Effects of Multidisciplinary Therapy

Background/Aims: Ghrelin and leptin play important roles in the physiopathology of eating disorders, starting generally in infancy and adolescence. The aim of this study was to evaluate the effects of multidisciplinary short-term therapy on ghrelin and leptin concentrations, bulimia nervosa symptoms, binge eating disorder symptoms, body composition, and visceral and subcutaneous fat in obese adolescents. Methods: Twenty obese adolescents with simple obesity (BMI >95th percentile, 36.93 ± 4.14, CDC) were submitted to multidisciplinary (nutrition, psychology, exercise and clinical) therapy. Plasma ghrelin and leptin concentrations were measured by radioimmunoassay. Bulimic and binge eating behaviors were measured by the Bulimic Investigation Test Edinburgh and the Binge Eating Scale, respectively. Visceral and subcutaneous fat were measured by ultrasonography and body composition by plethysmography. Results: Significant reductions were observed in body weight (101.04 ± 11.18 to 94.79 ± 10.94 kg), BMI (36.93 ± 4.14 to 34.27 ± 4.78), fat% (41.96 ± 6.28 to 39.14 ± 7.62%), visceral fat (4.34 ± 1.53 to 3.41 ± 1.12 cm), leptin concentration (20.12 ± 6.47 to 16.68 ± 8.08 ng/ml), prevalence of bulimia nervosa (100 to 67%) and binge eating disorder symptoms (40 to 17%). Conclusion: Short-term multidisciplinary therapy was effective in improving body composition, visceral fat, leptinemia and eating disorders in obese adolescents.

Beliefs of adolescent girls concerning the severity and prevalence of bulimia nervosa

The beliefs of adolescent girls concerning an eating disorder problem were investigated. A vignette describing a fictional 16-year-old girl meeting diagnostic criteria for bulimia nervosa (BN) was presented to 522 high school students, followed by a series of questions concerning the severity and prevalence of the problem described. Most respondents believed that BN is a serious problem whose sufferers are deserving of sympathy. However, BN was perceived to be common among adolescent girls, far more common than estimates from epidemiological research would suggest, and many participants had at some stage thought that it “might not be too bad” to have such a problem. In addition, participants with a high level of eating disorder symptoms considered the prevalence of BN to be higher, and its symptoms more acceptable, than asymptomatic participants. These findings suggest that the perception of bulimic behaviours as normative and/or desirable may need to be addressed in prevention programs.

Beliefs of women concerning the severity and prevalence of bulimia nervosa

Few studies have examined attitudes towards eating-disordered behaviour among women in the general population. A vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) was presented to a community sample of women aged 18-45. Respondents (n = 208) were asked a series of questions concerning the severity and prevalence of the problem described. Most respondents viewed BN as a distressing condition whose sufferers are deserving of sympathy. However, more than one-third of respondents had at some stage believed that it 'might not be too bad' to be like the person described in the vignette. Most respondents believed that the prevalence of the problem described among women in the community was likely to be between 10 % and 30 % (48.6%) or between 30% and 50 % (23.1 %). Individuals with a clinically significant eating disorder (n = 13, 6.3%) were more likely to perceive the symptoms of BN as being acceptable, and its prevalence higher, than individuals with no eating disorder diagnosis. Information concerning the medical and psychological sequelae of BN and other eating disorders might usefully be incorporated in prevention programmes. Prospective community-based research is required to elucidate the nature of the relationship between perceived acceptability of eating disorder symptoms and actual eating disorder psychopathology. Extension of the present research to examine the views of women in other cultures would also be of interest.

Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients.

Although psychiatric patients with eating disorders are known to be at risk for a variety of health problems, relatively little is known about eating disorders and associated health problems in other populations. An epidemiological study was conducted to investigate health problems and impairment associated with bulimia nervosa (BN) and binge eating disorder (BED) among female primary care and obstetric gynaecology patients. Psychiatric disorders, physical illnesses, disabilities, functional status and stress were assessed among 4651 female patients (age range:18 to 99 years) at 8 primary care and 7 obstetric gynaecology clinics throughout the United States. Two hundred eighty-nine women (62%) were diagnosed with BN or BED. The prevalence of BN was approximately 1% among young and middle-aged women. The prevalence of BED increased steadily from early (3.3%) through middle (8.5%) adulthood. Anxiety disorders, mood disorders and diabetes were much more common among women with BN or BED than among women without these eating disorders. Women with BN or BED reported markedly poorer functioning and much higher levels of disability, health problems, insomnia, psychosocial stress and suicidal thoughts than did women without BN or BED, after co-occurring psychiatric disorders were controlled statistically. Yet, fewer than one of ten cases of BN or BED was recognized by the patients' physicians. Patients with BN or BED often experience considerable disability, impairment, distress and co-occurring illnesses. Increased recognition of eating disorders may be a crucial step towards encouraging more patients to seek treatment for these disabling conditions.

Prevalence of eating disorders and weight control practices in Germany in 1990 and 1997.

To investigate whether the prevalence of bulimic behaviors and weight control practices changed between 1990 and 1997. In November 1997, we surveyed a representative sample of 2,130 adult subjects in West Germany and 2,155 subjects in East Germany. We asked subjects about binge eating, vomiting, use of laxatives, appetite suppressants and diuretics, and about dieting, weighing, and exercise. As the same questions had been used in a representative survey (N = 1,773) in autumn 1990 in West Germany, trend comparisons for prevalence between 1990 and 1997 are possible. The prevalence of severe eating binges twice a week dropped nonsignificantly between 1997 and 1990 from 3.1% to 2.4% in men and from 2.3% to 1.3% in women. In men, the prevalence of binge eating disorder dropped nonsignificantly from 2.4% to 1.5%, the prevalence of bulimia nervosa from 2.1% to 1.1%. In women, the prevalence of binge eating disorder dropped nonsignificantly from 1.5% to 0.7% and that of bulimia nervosa from 2.4% to 1.1%. The prevalence of bulimic behaviors decreased slightly during 1990 and 1997 in the West German population.

Gender and Ethnic Differences in the Relationship Between Body Esteem and Self-Esteem

Gender and ethnic differences in the relationship between body esteem and self-esteem were examined to assess the degree to which these variables change in relation to each other over time. Difference scores (between Time 1 and Time 2, 1 week apart) were obtained using the Self-Esteem Scale (M. Rosenberg, 1979) and the Body Esteem Scale (S. L. Franzoi & S. A. Shields, 1984) for 163 White women, 140 White men, 55 Black women, and 37 Black men. The results indicated that the correlation of the difference scores was stronger for the group of White women than for the other 3 groups, suggesting that changes in self-esteem parallel changes in body esteem more for White women than for White men, Black men, and Black women. The findings are discussed in relation to the prevalence of bulimia nervosa among White women.

Diabetes mellitus and eating disorders: a multicenter study on the comorbidity of the two diseases

Because diet is a key issue in the treatment of diabetes mellitus, it is assumed that these patients are prone to eating disorders. In a multicenter study, we have therefore assessed the prevalence of eating disorders in 662 patients with insulin dependent diabetes mellitus (IDDM) ( n=340) and non-insulin–dependent diabetes mellitus (NIDDM) ( n=322). A two-stage study combining self-rating questionnaires and a standardized interview was carried out. We found a prevalence of eating disorders of 5.9% (lifetime prevalence of 10%), irrespective of gender and type of diabetes; 4.1% of the whole sample reported intentional insulin undertreatment or omission. When patients were stratified according to IDDM and NIDDM, there was no difference in the prevalence of all eating disorders (point prevalence 5.5% vs. 6.5%, lifetime prevalence 10.0% vs. 9.9%). Prevalence of bulimia nervosa (BN) was more frequent in IDDM patients (point prevalence 1.5% vs. 0.3%, lifetime prevalence 3.2% vs. 1.9%) and binge eating (BED) was more frequent in NIDDM patients (point prevalence 1.8% vs. 3.7%, lifetime prevalence 2.6% vs. 5.9%). We conclude that eating disorders seem to be equally frequent in IDDM and NIDDM patients. However, there might be different features of eating disorders in both types of diabetes.