To examine functional impairment associated with bulimic behaviors in a community sample of men and women.
Binge eating, purging, fasting, extreme weight and shape concerns, and "days-out-of-role" were assessed in a community sample of men (n = 1,290) and women (n = 1,757) aged 15-94 years.
Participants who reported regular eating disorder behaviors had higher levels of functional impairment than those who did not. This was the case for both men and women and for each of the behaviors assessed, although differences between purgers and nonpurgers were not statistically significant. Also in both men and women, participants who reported eating disorder behaviors and weight or shape concerns had higher levels of impairment than those who reported these behaviors in the absence of weight or shape concerns. In multivariate analysis, binge eating, fasting and weight or shape concerns all contributed to the likelihood of impairment in men, whereas only the presence of weight or shape concerns was significantly associated with impairment in women.
Whereas bulimic behaviors are associated with elevated levels of functional impairment in both men and women, weight or shape concerns may be more central to the experience of this impairment in women.
"Recent studies have also begun to measure the non-health care impacts of ED, including work productivity and impairment (Lynch et al., 2010; Mond & Hay, 2007); however, specific estimates of lost productivity associated with ED are still lacking. In a recent review of 18 economic evaluations of ED (Stuhldreher, 2012), none evaluated lost productivity in the US. "
[Show abstract][Hide abstract] ABSTRACT: Background: Very little is known about the economic burden of eating disorders (ED) and related mental health comorbidities. Methods: Using 5. years of data from the U.S. Medical Expenditures Panel Survey, we estimated the difference in annual health care costs, employment status, and earned income (2011 US$) between individuals with current ED compared to those without ED. We further estimated the contribution of mental health comorbidities to these disparities in health care costs, employment and earnings. Results: Individuals with ED had greater annual health care costs ($1869, p. =. 0.012), lower but borderline significant employment rates (OR. =. 0.67, 95% CIs [0.41, 1.09]), and lower but not statistically significant earnings among those who were employed ($2093, p. =. 0.48), compared to individuals without ED. Among individuals with ED, the presence of mental health comorbidities was associated with higher but not statistically significant health care costs ($1993, p. =. 0.17), lower borderline significant odds of employment (OR. =. 0.41, 95% CIs [0.14, 1.20]), and significantly lower earnings ($19,374, p. <. 0.01). Conclusions: Treatment and prevention of ED may have broader economic benefits in terms of heath care savings and gains in work productivity than previously recognized. This exploratory study justifies large scale evaluations of the societal economic impact of eating disorders and comorbidities.
"In the literature, data on gender differences related to the mental HRQL are conflicting. While some studies have found it to be associated with equal impairment (Mond and Hay, 2007) and/or greater distress in women compared to men (Lewinsohn et al., 2002), a recent study found that the mental HRQL SF-36 subscale was associated with greater impairment in men compared to women (Mitchison et al., 2013). More research is needed before any firm conclusions can be made. "
[Show abstract][Hide abstract] ABSTRACT: This study compared the mental and physical health related quality of life (HRQL) of 40 obese persons with BED with 20 age-, gender and body mass index (BMI) matched obese persons without BED and 40 age- and gender matched non-obese volunteers. Variables contributing to the variability in HRQL were identified. Participants were asked to fill in the MOS 36-item Short Form Health Survey (SF-36), the Symptoms Checklist-90 (SCL-90), the Baecke questionnaire, the bulimia subscale of the Eating Disorder Inventory and the Body Attitude Test. All participants also performed a 6-minute walk test (6MWT). BED patients showed a significant impaired physical and mental HRQL compared with obese and non-obese control groups. In the BED-group female participants showed a significantly more impaired mental HRQL than male participants (40.0±21.2 versus 66.6±10.1). The distance achieved on the 6MWT (512.1±75.8 m) explained 22.5% of the variability in physical HRQL in the obese BED-group while gender and the SCL-90 depression score (39.1±12.2) explained 47.1% of the variability in mental HRQL. The present findings suggest that the treatment of obese individuals with BED might benefit by giving more attention to HRQL, depressive symptoms and physical fitness.
Psychiatry Research 04/2014; DOI:10.1016/j.psychres.2014.01.015 · 2.47 Impact Factor
"The number of published population and community-based studies is gradually increasing in the ED field, and these are adding to an evidence-base that will help us to more accurately characterize EDs in future. For instance, this evidence-base has already aided our shifting away from the long-held perception that EDs are the domain of the wealthy, White, young female toward the notion that disordered eating and body image disturbance are experienced by males and females15,16 of all ages17 and ethnicities18,19 and who live in both developed and developing countries.20,21 Nonclinical studies have also been published that examine the genetic and environmental influences on EDs. "
[Show abstract][Hide abstract] ABSTRACT: The aim of this review was to summarize the literature to date regarding the sociodemographic, environmental, and genetic correlates of eating disorders (EDs) in adults.
A keyword search was entered into Scopus (SciVerse, Elsevier) to identify relevant articles published in English up until June 2013. Articles were assessed against a range of a priori inclusion and exclusion criteria.
A total of 149 full-text articles were found to be eligible for the review and included 86 articles with data on sociodemographic correlates, 57 on environmental correlates, and 13 on genetic correlates. Female sex, younger age, sexual and physical abuse, participation in esthetic or weight-oriented sports, and heritability were found to be most consistently associated with higher ED prevalence and incidence. Conversely, ethnicity, socioeconomic status, education, and urbanicity did not appear to have strong associations with ED epidemiology.
More community-based research, with an equal representation of males, needs to be conducted to confirm the current findings and provide evidence for emerging factors that may be related to EDs.
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