Disordered Eating: Symptoms of Bulimia
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Headline

In 2005, Hispanic and white non-Hispanic female students engaged in disordered eating at a higher rate than non-Hispanic black female students (7 percent for both Hispanics and non-Hispanic whites, versus 4 percent for non-Hispanic blacks). (See Figure 2)

Importance

Both taking laxatives and vomiting to lose weight are symptoms of bulimia, an eating disorder. Bulimia is characterized by a cycle of excessive eating (binging) followed by vomiting (purging), the use of laxatives, or other means of weight control. Bulimia, like anorexia, is a psychological disorder, which often begins with dissatisfaction about one's body.¹

The practices of vomiting and using laxatives can lead to serious medical problems. Self-induced vomiting, which exposes one's mouth, esophagus, and colon to acidic gastric contents, can lead to oral complications (such as erosion of tooth enamel and swelling and soreness of salivary glands), ulcers, ruptures of the esophagus, and other health problems.² The use of laxatives can cause intestinal and systemic complications such as a dependency on laxatives or the loss of colonic function.

Trends

From 2003 to 2005, the percent of all youth in grades 9 through 12 who reported vomiting or taking laxatives to control their weight decreased from 6 percent in 2003 to 5 percent in 2005. (See Table 1) Female students followed a similar trend, decreasing from 8 percent in 2003 to 6 percent in 2005.

In 2005, about 5 percent of all youth in grades 9 through 12 reported vomiting or taking laxatives to control their weight. (See Figure 1)

Differences by Gender

Females are more likely than males to engage in disordered eating, with 6 percent of females reporting vomiting or using laxatives to control weight in 2005, compared with 3 percent for males. (See Figure 1)

Differences by Race and Ethnicity³

In 2005, Hispanic and white non-Hispanic female students engaged in disordered eating at a higher rate than non-Hispanic black female students (7 percent for both Hispanics and non-Hispanic whites, versus 4 percent for non-Hispanic blacks). (See Figure 2) Differences by race were not significant among males.

Related Indicators

Adolescents Who Feel Sad or Hopeless, Overweight Children and Youth

State and Local Estimates

2005 estimates for selected states and cities from the Youth Risk Behavior Survey (YRBS) can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm

International Estimates

None Available

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National Goals

Included in the Healthy People 2010 goals is the goal to "reduce the relapse rates for persons with eating disorders." There is no target rate because there are no concrete national figures with the number of people suffering from eating disorders. Therefore, the goal is to help those patients who get treatments stay healthy. For bulimics, the relapse rate is approximately twenty-five percent in the first three months and fifty percent after nine months.⁴

What Works: Programs and Interventions that May Influence this Indicator

Click here to view examples of programs and interventions that research has evaluated for this indicator. View programs

Research References

¹National Institute of Mental Health, "Eating Disorders: Facts about Eating Disorders and the Search for Solutions." NIH Publication No. 01-4901. Available at: http://www.nimh.nih.gov/Publicat/eatingdisorders.cfm

²American Psychiatric Association. "Disease Definition, Epidemiology, and Natural History." Table 7: "Physical Complications of Bulimia Nervosa." Available at: http://www.psych.org/psych_pract/treatg/pg/eating_revisebook_4.cfm

³Race/ethnicity estimates from 1999 and later are not directly comparable to earlier years due to federal changes in race definitions. In surveys conducted in 1999 and later, respondents were allowed to select more than one race when selecting their racial category. Estimates presented here only include respondents who selected one category when choosing their race.

⁴U.S. Department of Health and Human Services. Healthy People 2010, 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000. http://www.health.gov/healthypeople/document/HTML/Volume2/18Mental.htm#_Toc486932699 (See Goal 18-5).

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Definition

The data presented in this indicator are based on the percent who report vomiting or taking laxatives to lose weight or to keep from gaining weight in the past 30 days. Both vomiting and taking laxatives to lose or control weight are unhealthy dietary behaviors and are symptoms of bulimia. However, students who have engaged in these behaviors are not necessarily bulimic. More information, such as the length and frequency of these behaviors, is needed to diagnose someone with bulimia.

Data Source

Centers for Disease Control and Prevention. Surveillance Summaries:
Data for 1995: September 27, 1996. MMWR 1996; 45 (No. SS-4): Table 34. http://www.cdc.gov/mmwr/preview/mmwrhtml/00043812.htm#00001952.htm
Data for 1997: August 14, 1998. MMWR; 47(No. SS-3): Table 34. "http://www.cdc.gov/mmwr/preview/mmwrhtml/00054432.htm#00003375.htm
Data for 1999: June 9, 2000. MMWR 2000; 49(No. SS-5): Table 38. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4905a1.htm#tab38
Data for 2001: June 28, 2002. MMWR 2002; 51(No. SS-4): Table 38. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5104a1.htm#tab38
Data for 2003: May 21, 2004. MMWR 2004; 53(No. SS-2): Table 64. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5302a1.htm#tab64
Data for 2005: June 9, 2006. MMWR 2006; 55 (No. SS-5): Table 66. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm

Raw Data Source

Youth Risk Behavior Survey (YRBS) http://www.cdc.gov/nccdphp/dash/yrbs/index.htm

Approximate Date of Next Update

Summer 2008

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