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Correlates of the use of purging and non-purging methods of weight control in a community sample of women


  • Jonathan J. Mond,

  • Phillipa J. Hay,

  • Bryan Rodgers,

  • Cathy Owen,

  • James Mitchell

  • Phillipa Hay, Professor and Head
    Discipline of Psychiatry, School of Medicine, James Cook University, Townsville, Queensland, Australia

  • Bryan Rodgers, Professor
    National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia

  • Cathy Owen, Professor and Head
    Medical Education Unit, Medical School, Australian National University, Canberra, Australian Capital Territory, Australia

Jonathan Mond, Research Scientist (Correspondence); James Mitchell, Professor and Head
Neuropsychiatric Research Institute, 120 8th St. South Fargo, North Dakota 58103, USA.


Objective: To inform the classification of bulimic-type eating disorders, the correlates of purging and non-purging methods of weight control were examined in a large community sample of young adult women reporting recurrent episodes of binge eating.

Method: Scores on self-report measures of eating disorder psychopathology, functional impairment and health-service utilization were compared among individuals who reported (recurrent episodes of binge eating and) the use of either purging (self-induced vomiting, laxative or diuretic misuse; n = 41) or non-purging (extreme dietary restriction, excessive exercise, or use of diet pills; n = 62) methods of weight control. Individuals who reported recurrent binge eating in the absence of extreme weight control behaviours (n = 442) were also included in the analysis.

Results: Non-purgers tended to be younger and heavier and have higher levels of eating disorder psychopathology and functional impairment than purgers and non-compensating binge eaters, however these differences were not statistically significant. Purgers were more likely than non-purgers to have sought treatment specifically for a problem with eating, however this difference was no longer significant after age and body mass index were statistically controlled. In multivariate analysis, frequency of extreme dietary restriction was the best predictor of functional impairment.

Conclusions: These findings call into question the validity of subtyping of bulimia nervosa into purging and non-purging forms as outlined in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.

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