A Comparison of Bulimic Tendencies In College and Noncollege Women

Following research by Hesse-Biber, Marino, & Watts-Roy (1999) on individuals with undiagnosed eating problems, the bulimic tendencies of college (n = 57) and noncollege women (n = 56), ages 18 – 22, were compared in order to assess the effect that living on a college campus has upon disordered eating. Participants were given the Wonderlic Personnel Test and a researcher-designed 43-item questionnaire. Both group’s results from the Wonderlic Personnel Test and the questionnaire were compared. The constructs within the questionnaire (physical attractiveness, self-control, achievement seeking) were significantly correlated with the final bulimia index for both groups. However, no significant differences between the two groups were found. According to the results of the current study, living on a college campus has no significant effect upon bulimic tendencies. Bulimic Tendencies 3 A Comparison of Bulimic Tendencies In College and Noncollege Women Bulimia Nervosa is an eating disorder typified by regular periods of binge eating and the use of extreme measures to prevent weight gain, both of which are accompanied by secrecy, feelings that one's behaviors are out of control, and a distorted self-image (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 2000). Typically, binge eating and Bulimia Nervosa are associated with adolescent and college-aged women (Lakin & McClelland, 1987). Margaret Lowe (2003) speculated that women’s self-image problems developed alongside the development of coed colleges. That is, the appearance of men students on previously all-female college campuses was detrimental to women’s self-image. Due to the strong correlation between self-image and disordered eating patterns, much research has focused upon the diagnosis and treatment of college women with bulimia. Despite efforts to increase awareness of bulimia on college campuses, a growing body of research indicates that there may be a population of undiagnosed women suffering from severe bulimic tendencies. Hesse-Biber, Marino, & Watts-Roy (1999) called the area within which undiagnosed sufferers linger the “gray zone” and define the gray zone to be composed of “the population who exhibits problematic eating patterns that are not severe enough to be classified as clinical disorders” (p. 386). Taking into consideration those within the gray zone is of great importance to eating disorder research. Studying the characteristics and common tendencies amongst those within the gray zone may provide key insights into the treatment and prevention of eating disorders. Bulimic Tendencies 4 For this reason, much research has focused upon those within the gray zone. Pyle, Mitchell, Eckert, Halvorson, Neuman, & Goff (1983) found that 4.5% of 1,355 nondiagnosed freshman women college students met the Diagnostic and Statistical Manual of Mental Disorders (DSM) requirements for bulimia and additional standards for weekly binge eating. Pyle et al. (1983) differentiate between students with bulimic tendencies and bulimic patients in their conclusion that “bulimic” students are more likely to use fasting rather than self-induced vomiting as a weight-control method. Despite the subtle difference in weight-control methods, the study found striking similarities between the non-diagnosed population and bulimic patients. Pyle et al. (1983) discovered that fasting is common in the early stages of full-scale bulimia. Therefore, the students who regularly engage in fasting are exhibiting behaviors that commonly precede development of the bulimic syndrome. This is significant because it illustrates that these students are traveling the destructive path towards Bulimia Nervosa. Similarly, Carter & Rudd (2005) surveyed 800 student-athletes at The Ohio State University regarding subclinical disordered eating behaviors. Their aim was to identify student-athletes within the gray zone. The two-year study revealed that 19% of women athletes and 12% of men athletes reported subclinical disordered eating behaviors in Year One of the survey, and 17% of women athletes and 9% of men athletes reported subclinical disordered eating in Year Two. Furthermore, Carter & Rudd (2005) concluded that higher subclinical rates were found amongst lean sport athletes than non lean sport athletes and overall a greater number of athletes qualified for subclinical diagnosis of eating disorders than clinical eating disorders. This study lends support to Bulimic Tendencies 5 the gray zone hypothesis that there are a growing number of undiagnosed college students suffering from disordered eating. Likewise, Zuckerman, Colby, Ware & Lazerson (1986) sought to identify bulimic behaviors in a college population comprised of college freshmen and seniors. According to the survey results, 50% of the women classified themselves as overweight and 28% reported that they “often,” “very often,” or “always” felt anxious about gaining weight (Zuckerman et al., 1986, p. 1135). This is significant because preoccupation with one’s weight is highly correlated with development of Bulimia Nervosa. Furthermore, Zuckerman et al. (1986) discovered that 23% of 305 college freshmen women reported an average of at least one eating binge each week and the utilization of one or more of the following methods of weight control: fasting, diuretics, laxatives, or self-induced vomiting. In other words, not only did they find that almost a quarter of the freshmen women population in this study binged regularly, but the same amount admitted to compensatory behaviors. Both regular bingeing and compensatory behaviors are listed as criterion for Bulimia Nervosa in the DSM-IV-TR (2000) and signify increased risk for developing the disorder. Zuckerman et al. (1986) concluded that “bulimic symptoms represent a substantial problem among college students, especially women. It is therefore crucial to focus research attention on nonclinical adolescent populations” (p. 1136). Thus, the researchers recognized the need to look within the gray zone and examine undiagnosed populations in order to more effectively treat and prevent bulimia. In a similar study, Cooley & Toray (1996) reported that 94% of 225 college freshmen women stated they desired to weigh below their current weight. Dissatisfaction with current weight and low body esteem are included in the DSM-IV-TR (2000) criterion Bulimic Tendencies 6 for Bulimia Nervosa. The Cooley & Toray (1996) finding suggests that a large percentage of freshmen women are at risk for developing bulimia. To further their research, Cooley & Toray (1996) administered a second survey to 104 of the original 225 college students seven months after the original survey. The results showed that figure dissatisfaction was the greatest predictor of bulimia development; that is, women who exhibited the greatest amount of dissatisfaction with their bodies at the time of the first survey were most likely to have developed bulimia at the time of the second survey. This study is meaningful because it followed a group of freshmen women through the majority of their first year in college. The results suggest that the college environment may have some correlation with body dissatisfaction and development of bulimia among women students. Examining a slightly different population, Lakin & McClelland (1987) explored binge eating and bulimic tendencies within a high school population of 126 students. Fifty-three percent reported binge eating. Of those, 55% admitted to beginning binge eating between 10 and 14 years of age. These findings are significant when examining bulimic behaviors in older populations because it reveals the importance of early prevention. By the time college-aged individuals are examined for disordered eating, it is probable that they have been partaking in disordered eating behaviors since early adolescence. This expands the gray zone to include preteen and early teenage populations and further asserts the importance of examining undiagnosed populations. Still, the majority of research thus far utilizes college student subjects, specifically freshmen. No one has systematically examined bulimic behaviors in an undiagnosed noncollege, college-aged population. The current study sought to compare bulimic Bulimic Tendencies 7 tendencies in college (n = 57) and noncollege women (n = 56) in order to determine possible causes of bulimic symptoms. Specifically, this study looked at gray zone populations both inside and outside a college environment in hopes of discovering those bulimic behaviors attributable to a college setting. Likewise, the current study encompassed more than freshmen-aged subjects; rather, the research included women ages 18 – 22. This was decided to be the best option since the study is an attempt to measure differences between college and noncollege populations. Utilizing solely freshmen would fail to provide enough reliability in that the first-year students have been enrolled in college for less than one year. Therefore, the age group was set at 18 – 22 so that the subjects would have had enough time to experience and feel the effects of life on a college campus, a hypothesized predictor of bulimic tendencies. It is imperative to know the causes behind bulimic tendencies so that they can be addressed among the female college population. Comparing college and noncollege populations may provide invaluable insight into factors which increase the risk of entering the gray zone or of progressing from the gray zone to a clinical diagnosis of Bulimia Nervosa. Method Participants The two survey populations consisted of 113 women ages 18 – 22, either current college students (n = 57) or women who had never attended college (n = 56). The current college student participants were students at Wittenberg University, a small, private university in Ohio. Student participants responded to advertisements posted in an academic building and received extra-credit in their classes for participation in the study. Bulimic Tendencies 8 The nonstudent population was from the surrounding community. This population responded to flyers posted around the city and received five dollars for participation. Regarding the participants' demographic background, all were single and all but two of the student population (n = 55) and the entire nonstudent population (n = 56) were Caucasian. Materials Based on the bulimia-related questionnaire utilized by Pyle et al. (1983) and the International Personality Item Pool (IPIP) website (2007), a researcher-designed 43-item questionnaire was administered to the participants. The questionnaire was designed to measure bulimic behaviors and self-ratings on physical attractiveness, self-control, and achievement seeking in the participants. In addition, the Wonderlic Personnel Test was administered. The Wonderlic Personnel Test served to measure any differences in intelligence between the two groups. The questionnaire is attached in the appendix. The front page of the Wonderlic IQ test provided examples of questions on the test and explained the 12-minute time constraint within which participants were required to complete as many of the 50 questions as possible. Each question on the test is more difficult than the one before, and test-takers were encouraged to answer the questions in the order in which they appeared on the test. Test-takers were informed that they were not expected to complete all 50 questions. The researcher-designed questionnaire consisted of three sections. The first section was based on a Likert-rating scale with a rating of 1 signifying "very inaccurate," 2 as "moderately inaccurate," 3 meaning "neither inaccurate nor accurate," 4 signifying "moderately accurate," and 5 depicting "very accurate." In this section, participants rated Bulimic Tendencies 9 30 statements drawn from the IPIP website according to how accurately they felt the statements described them. Statements included "I am considered attractive by others" and "I excel in what I do." In the second section, response options were true/false, and the statements dealt with the presence and/or absence of bulimic tendencies in one's life. The eight statements in this section were drawn from research done by Pyle et al. (1983) and included statements such as "I tend to eat high calorie, easy-to-digest food in large quantities" and "I enjoy going out to eat with my friends." The final section contained five statements drawn from research by Pyle et al. (1983). This part of the questionnaire utilized a Likert-rating scale of "never," "at any time," "weekly," and "daily" and addressed the frequency of bulimic behaviors. Examples of statements within this section include "I never practiced self-induced vomiting" and "I have used diuretics." Procedure Participants were presented with an informed consent form upon entering the testing site. Next, the IQ test was given to each participant and they were asked to read the front page only and alert the test administrator upon completion. When the participant finished reading the first page, the test administrator fielded any administrative questions and then told the participants to begin. Following the passage of 12 minutes, the test administrator instructed the participants to stop taking the test. After completing the IQ test, participants were given the questionnaire. Not under any time constraints, participants were encouraged to take their time and answer each section honestly. Participants were finished with the study upon completion of the