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Bulimia: When Is a Binge a Binge?

Steven C. Dilsaver, MD
JAMA. 1988;259(1):45. doi:10.1001/jama.1988.03720010025024.
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To the Editor.  —In a recently published article in JAMA, Schotte and Stunkard1 reported that the incidence of bulimia defined by either DSM-III or DSM-IIIR criteria among college students is 1.3% for women and 0.1% for men. These conclusions, based on structured methods of data collection, seem sound. I have, however, questions about the questionnaire data.When is a binge a binge? Some of us might consider the hearty eating done on Thanksgiving Day to be a binge. There is a great deal of latitude for subjective interpretations of the question of whether one binges or not. The authors report that the frequency of binging on a monthly or more frequent basis was 44.7% among women. Was this based on the subject's perception or were the questions written to ensure conformity to the DSM-III or DSM-IIIR definition of a binge? This is a basic question for those interested in


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