Social patterning of overeating, binge eating, compensatory behaviours and symptoms of bulimia nervosa in young adult women: results from the Australian Longitudinal Study on Women’s Health

OBJECTIVE: To study social patterning of overeating and symptoms of disordered eating in a general population. DESIGN: A representative, population-based cohort study. SETTING: The Australian Longitudinal Study on Women’s Health (ALSWH), Survey 1 in 1996 and Survey 2 in 2000. SUBJECTS: Women (n 12 599) aged 18–23 years completed a questionnaire survey at baseline, of whom 6866 could be studied prospectively. RESULTS: Seventeen per cent of women reported episodes of overeating, 16 % reported binge eating and 10 % reported compensatory behaviours. Almost 4 % of women reported symptoms consistent with bulimia nervosa. Low education, not living with family, perceived financial difficulty (OR=1·8 and 1·3 for women with severe and some financial difficulty, respectively, compared with none) and European language other than English spoken at home (OR=1·5 for European compared with Australian/English) were associated with higher prevalence of binge eating. Furthermore, longitudinal analyses indicated increased risk of persistent binge eating among women with a history of being overweight in childhood, those residing in metropolitan Australia, women with higher BMI, smokers and binge drinkers. CONCLUSIONS: Overeating, binge eating and symptoms of bulimia nervosa are common among young Australian women and cluster with binge drinking. Perceived financial stress appears to increase the risk of binge eating and bulimia nervosa. It is unclear whether women of European origin and those with a history of childhood overweight carry higher risk of binge eating because of genetic or cultural reasons.