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Manual of Articles Sections 15 - 28
• Bulimia is often triggered when young women attempt restrictive diets, fail, and react by binge eating. (Binge eating involves consuming amounts of food that are larger than average portions within a two-hour period.)
Binge-Eating (Binge-Eating Disorder)
Who Develops Eating Disorders?
Age of Onset for Bulimia. A 1997 survey by the Centers for Disease Control of high school students reported that 4.5% induced vomiting after meals or used laxatives to lose weight. Estimates of the prevalence of bulimia nervosa among young women range from about 3% in adolescents to 10% in college women. Some experts claim that even these percentages grossly underestimate the problem because many people with bulimia are able to conceal their purging and do not become noticeably underweight. For example, a European study detected bulimic behavior in 14.4% of adolescents 14 to 16 years old, with full-blown bulimia observed in 1.8% of girls and 0.3% of boys.
When eating disorders occurs in young adults, men are more apt to conceal them, so the incidence among males may be underreported. One study of Navy men, for example, reported a prevalence of 2.5% for anorexia, 6.8% of bulimia, and 40% for binge eating. A 2001 study reported that the psychiatric and social profiles of men and women with eating disorders were very similar to each other, although profiles between men with eating disorders and men without were quite different. Sexual preference may affect the risk of specific eating disorders in men. One study reported that 42% of male civilians with bulimia reported that they were homosexual or bisexual while 58% of the men with anorexia were asexual.
Income Levels. Oddly enough, within developed countries there appears to be no difference in risk between the rich and the poor. Some studies suggest that those in lower economic groups may be at higher risk for bulimia.
Urban Life. City living is a risk factor for bulimia but it has no effect on risk for anorexia.
Intelligence. In one sample, people with eating disorders scored significantly higher than average on IQ tests. People with bulimia, but not anorexia, had higher nonverbal than verbal scores.
Excessively Physically Active People
Women Athletes and Dancers. Women in "appearance" sports, including gymnastics and figure skating, and in endurance sports, such as track and cross-country, are at particular risk for anorexia. Success in ballet also depends on the development of a wiry and extremely slim body. Estimates for episodes of eating disorders among such athletes and performers range from 15% to over 60%.
Male Athletes. Male wrestlers and light-weight rowers are also at risk for excessive dieting. One-third of high school wrestlers use a method called weight-cutting for rapid weight loss. This process involves food restriction and fluid depletion using steam rooms, saunas, laxatives, and diuretics. Although male athletes are more apt to resume normal eating patterns once competition ends, studies are showing that the body fat levels of many wrestlers are still well below their peers during off-season and are often as low as 3% during wrestling season. Of concern is a recently recognized body-image disorder, referred to as muscle dysmorphia, that occurs mostly in men who are preoccupied with weight lifting and perceive themselves as puny.
Men and Women in the Military. Studies are also showing a higher-than-average risk for eating disorders in men and women in the military. A study of eating behavior on one Army base reported that 8% of the women had an eating disorder, compared to 1% to 3% in the civilian female population.
• If the person has stopped eating meat only to avoid fat rather than from other motives, such as love of animals.
Young People with Diabetes or Other Chronic Diseases
Diabetes. Eating disorders are particularly serious problems in people with either type 1 or type 2 diabetes.
• Both bulimia and anorexia are common in type 1 diabetes. Some experts report that one-third of insulin-dependent patients have an eating disorder, most often because diabetic women omit or under-use insulin in order to control weight. If such patients develop anorexia, their extremely low weight may appear to control the diabetes for a while. Eventually, however, if they fail to take insulin and continue to lose weight, these patients develop life-threatening complications. [See also How Serious Are Eating Disorders?]
• Before puberty, girls ate quantities of food appropriate to their body weight, were satisfied with their bodies, and noted their depression increased with lower food intake.
This study was reporting on girls without eating disorders, but it certainly suggests patterns that can lead to eating problems, particularly in girls who go through puberty early.
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