EATING DISORDERS IN YOUNG WOMEN--PREVALENCE AND RISK

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DESCRIPTION (Adapted from the Applicant's Abstract): Eating disorders involving recurrent binge eating (binge eating disorders) pose a significant risk to the health and psychological adjustment of young women. Current knowledge of binge eating disorders is limited by a) the virtual exclusion of minority women from study samples; b) the paucity of studies of women with spectrum binge eating disorders; and c) the over reliance in risk factor studies on retrospective assessment of exposure to risk. As Aim I, the proposed study will assess a cohort of 2,379 young adult black and white women to describe the spectrum of binge eating disorders. Using state-of-the-art case finding interview methods, we will determine prevalence of bulimia nervosa (BN), binge eating disorder (BED), and their spectrum variants (defined as meeting all but one of the criteria required for full syndrome diagnosis); we will also identify presence of current Axis I psychiatric disorders. To determine clinical significance of BN, BED, and their spectrum variants in this community-based sample, we will compare women with a binge eating disorder and healthy controls on measures of obesity and psychological adjustment. The association of race and concomitant variables with eating disorder cases and controls will be examined. Aim II of the study is to develop an empirically based, multifactorial model of risk for binge eating disorders that considers three major risk domains: familial context, constitutional vulnerability, and personal vulnerability. For assessment of exposure to risk, data will be utilized that have been collected prospectively and longitudinally over a period of ten years in this exceptionally well-maintained cohort. We will examine race differences in the relative contribution of risk factors to the development of binge eating disorders; determine specificity of risk; and compare exposure to risk in women with full syndrome versus women with spectrum binge eating disorders. Our study should generate information relevant for primary prevention by identifying high risk groups and risk factors that may be amenable to change.