Prevalence and Long-Term Course of Lifetime Eating Disorders in an Adult Australian Twin Cohort

School of Psychology, Flinders University, Adelaide, South Australia, Australia.
Australian and New Zealand Journal of Psychiatry (Impact Factor: 3.41). 03/2006; 40(2):121-8. DOI: 10.1111/j.1440-1614.2006.01758.x
Source: PubMed


Few studies exist that have examined the spectrum and natural long-term course of eating disturbance in the community. We examine the lifetime prevalence and long-term course of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in an adult female twin population.
Female twins (n = 1002) from the Australian Twin Registry, aged 28-39 years, were assessed using the Eating Disorder Examination, revised to yield lifetime diagnostic information. For women with lifetime eating disorders, the assessment occurred, on average, 14.52 years (SD = 5.65) after onset of their disorder.
In accordance with other community studies, we found a 1.9% lifetime prevalence of AN, with an additional 2.4% who met the criteria for 'partial AN' (absence of amenorrhea). Criteria for BN were met by 2.9% of the women, an additional 2.9% of women met criteria for binge eating disorder, while 5.3% met criteria for purging disorder unaccompanied by binge eating (EDNOS-p). Eleven (7%) of the women with lifetime eating disorders had a current eating disorder. Each diagnostic group continued to be differentiated by current eating pathology from women without lifetime eating disorders. Although approximately 75% of the women had a good outcome, less than 50% of each diagnostic group was asymptomatic.
Eating disorders tend to improve over time often reaching subdiagnostic levels of severity, but only a minority of sufferers becomes asymptomatic. The DSM-IV diagnosis EDNOS needs to be considered in studies of the prevalence and course of eating disorders.

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    • "Bulimia nervosa is characterised by a binging and purging behaviour and a preoccupation with weight and shape (American Psychiatric Association, 2000b; World Health Organisation, 1994b). In addition to those who fulfil diagnostic criteria for an eating disorder, a much larger number suffer from subthreshold forms of eating disorders (Bulik, Reba, Siega-Riz, & Reichborn-Kjennerud, 2005; Wade, Bergin, Tiggemann, Bulik, & Fairburn, 2006). "

    Sport Education and Society 11/2015; DOI:10.1080/13573322.2015.1107829 · 1.29 Impact Factor
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    • "Key Words: Stigmatization, bulimia nervosa, knowledge, eating disorder symptoms (J Nerv Ment Dis 2015;203: 00–00) B ulimia nervosa (BN) affects a substantial proportion of the population and is associated with distress and role impairment (Hay, 2003; Hay and Mond, 2005). However, only a minority of individuals with BN seek appropriate professional treatment (Hudson et al., 2007; Swanson et al., 2011; Wade et al., 2006). It has been proposed that one of the main barriers to treatment seeking among individuals with these disorders is the fear of stigma (Becker et al., 2004; Hepworth and Paxton, 2007). "
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    ABSTRACT: Widely held stigmatizing attitudes and beliefs toward bulimic eating disorders may lead to self-blame and reduced treatment seeking. Knowledge and familiarity with mental disorders may help decrease associated stigma. However, these relationships are not well understood in bulimia nervosa (BN). A community sample of 1828 adults aged 18 to 70 years completed a survey assessing stigmatizing attitudes and beliefs toward BN, knowledge and familiarity with the disorder, as well as levels of eating disorder symptoms. Knowledge of BN was negatively associated with three dimensions of stigmatization, personal responsibility (ρ = -0.28), unreliability (ρ = -0.19), and advantages of BN (ρ = -0.23). Familiarity revealed no association with stigmatization. Both men and women with high levels of eating disorder symptoms perceived BN as less serious than the participants with low levels of symptoms. Increasing community knowledge about bulimia may help mitigate stigmatization and perceived barriers to treatment.
    Journal of Nervous & Mental Disease 03/2015; 203(4). DOI:10.1097/NMD.0000000000000275 · 1.69 Impact Factor
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    • "Eating disorders are not the 'preserve' of females, the wealthy or 'westerners'. In the general population, lifetime prevalence of anorexia nervosa is around 1% in women and < 0.5% in men, bulimia nervosa around 2% in women and 0.5% in men, and binge eating disorder around 3.5% in women and 2.0% in men (Favaro et al., 2003; Hudson et al., 2007; Keski-Rahkonen et al., 2007; Lewinsohn et al., 2000; Oakley Browne et al., 2006; Preti et al., 2009; Raevuori et al., 2009; Striegel-Moore et al., 2003; Wade et al., 2006). Point (three-month) prevalence in Australia is estimated at around 1% for bulimia nervosa, 2% for binge eating disorder (using the DSM-5 criteria of weekly frequency of binge eating and extreme weight control behaviours) and 3% for other eating disorders (specified or unspecified according to the new DSM-5 criteria) (Hay et al., 2008). "
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    Australian and New Zealand Journal of Psychiatry 11/2014; 48(11):977-1008. DOI:10.1177/0004867414555814 · 3.41 Impact Factor
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