Binge Eating and Substance Abuse
In the first attempt to systematically study gender differences in the relationship between binge eating and substance use among students, binge eating was linked with increased depressive symptoms in males and lowered self-esteem in females (Int J Eat Disord 1999; [26:24]5). Females were also more likely than males to attempt to compensate for their eating binges in inappropriate ways.
In 1997, 3,990 public and Catholic school students in Ontario, Canada, were surveyed on alcohol and other drug use with two questionnaires. Half the students were randomly assigned to a questionnaire that contained questions on dieting and bulimic behaviors, while the others completed a standard questionnaire that covered a broad range of areas related to substance abuse. A total of 2,016 students (1,084 females and 934 males) 10 to 20 years of age completed the survey containing questions on dieting and bulimic behavior. The questionnaire also included questions about frequency of alcohol and drug use in the past year, and problem drinking and drug use, as well as attitudes and beliefs about substance use, eating habits and depression and self-esteem.
Binge eating was significantly more common among females than males (46% versus 30%). The major difference occurred among females classified as the bingeing-compensating (BC) group. These students binged on food, then compensated with vomiting, laxatives, strict dieting or fasting, for example. Females outnumbered males by 3:1 in this group. Half of female BC students reported 3 or more bingeing episodes during the prior 12 months, and 14% reported 15 episodes or more. The compensating bingers were also significantly older.
Weight and dieting
Male students were more likely to report that they “were about the right weight.” Those who were dieting were more likely to describe themselves as “too thin” rather than “too fat.” The opposite was true of female students. Exercise was the most common method used by males and females to attempt to lose weight or to avoid gaining weight. Other methods included skipping meals, vomiting, and diet pills. Binge eaters, especially those in the BC group, were more likely to use all types of substances, particularly marijuana and drugs other than tobacco and alcohol.
Two screening questionnaires were used to report alcohol and other drug use. One in four males in the BC group scored 2 or more on the CAGE questionnaire and 1 in 2 reported problems as measured by the DAST (Drug Abuse Screening Test; Skinner, 1982) questionnaire. (CAGE is an anachronym that comes from 4 questions on the CAGE questionnaire: Have you felt a need to Cut down on your drinking? Have you ever felt Annoyed by criticism of your drinking? Have you ever had Guilty feelings about drinking? Do you ever take a morning Eye-opener? Mayfield, McLeod, and Hall, 1974).
Reprinted with permission from Eating Disorders Review
November/December 1999 Volume 10, Number 6
©1999 Gürze Books