The study has important policy implications: Based on their findings about the persistence of bulimic behavior and who is afflicted, the researchers argue that bulimia, which is currently classified as a disorder, would perhaps be more accurately described and treated as an addiction. As with drug and alcohol addictions, this would mean more federal, state and local treatment programs and fewer out-of-pocket insurance costs.
"The results illustrate the importance of having objective information on behavior rather than relying solely on data on diagnoses," Ham says.
According to Goeree, past research has over-relied on hospital admission data, creating a "sample selection bias" that overlooks those who exhibit bulimic behavior but do not receive or have the means to receive professional help.
"One explanation is straightforward: Girls with an eating disorder who are African American or come from low-income families are much less likely to be diagnosed. Who goes to the hospital? Those who have insurance. Who tends to have insurance? Wealthier, better-educated people," Goeree says, noting that another part of the difference may be due to parents' sensitivity to bulimic behaviors.
The findings also affect educational spending: "What we thought was that bulimia affects high income, high education white women. And, if that's the case, then you should try to tailor educational programs because education is expensive to the group that it will help the most," Goeree explains. "Now we're finding that it's really important to reach a completely different group than we thought."
According to the National Eating Disorders Association, more than 9 million females in the United States struggle wit
|Contact: Suzanne Wu|
University of Southern California