Use of extreme weight-control behaviors in the absence of binge eating with and without subjective bulimic episodes: A community-based study

Background and Methods: In a community sample of women who reported the use of extreme weight-control behaviors in the absence of binge eating, subgroups of participants who reported (n = 23) and who did not report (n = 42) recurrent subjective bulimic episodes (SBEs) were compared on a range of outcomes, including current levels of eating disorder and comorbid psychopathology. Results: Participants who reported SBEs had higher levels of eating disorder psychopathology, impairment in role functioning and general psychological distress, than those who did not. Scores on these measures among participants who reported SBEs were similar to those of eating disorder patients receiving specialist treatment, whereas those of participants who did not have recurrent SBEs tended to be intermediate between eating disorder patients and healthy women. Discussion: The findings are consistent with the hypothesis that it is the combination of SBEs and extreme weight-control behaviors, rather than extreme weight-control behaviors per se, that indicates clinical significance.