Features associated with diet pill use in individuals with eating disorders

Abstract

We investigated the relation between diet pill use and eating disorder subtype, purging and other compensatory behaviors, body mass index (BMI), tobacco and caffeine use, alcohol abuse or dependence, personality characteristics, and Axis I and Axis II disorders in 1,345 participants from the multisite Price Foundation Genetics Studies. Diet pill use was significantly less common in women with restricting type of AN than in women with other eating disorder subtypes. In addition, diet pill use was associated with the use of multiple weight control behaviors, higher BMI, higher novelty seeking, and the presence of anxiety disorders, alcohol abuse or dependence, and borderline personality disorder. Findings suggest that certain clinical and personality variables distinguish individuals with eating disorders who use diet pills from those who do not. In the eating disorder population, vigilant screening for diet pill use should be routine clinical practice.Correspondence to Dr Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill , 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, Voice: (919) 843 1689 Fax: (919) 966-5628, e-mail: cbulik@med.unc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptEat Behav. Author manuscript; available in PMC 2009 January 1. Published in final edited form as:Eat Behav. 2008 January ; 9(1): 73-81. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptKeywords Eating disorders; diet pills; weight control behaviors; novelty seeking Abuse of diet pills by individuals with eating disorders is well-documented clinically, with prevalence estimates reported as high as 50% (Celio et al., 2006;Mitchell, Pomeroy, & Huber, 1988;Roerig et al., 2003;Steffen, Roerig, Mitchell, & Crosby, 2006). However, empirical studies of features associated with abuse of diet pills are lacking. Given potential adverse effects associated with abuse of these agents (e.g., side effects, tolerance, withdrawal) (Carek & Dickerson, 1999;Dietz, 1981;Shekelle, Morton, & Maglione, 2003), particularly in populations already at elevated medical risk, it is important to explicate the nature of diet pill abuse and its consequences in individuals with eating disorders.Accordingly, the aim of this study were to report the prevalence of lifetime diet pill use across eating disorder subtypes and identify factors associated with their use. We hypothesized that individuals with the restricting type of anorexia nervosa (RAN) would use diet pills less frequently than those with other subtypes. This may ...

Patterns of co-morbidity of eating disorders and substance use in Swedish females

“…Consistent with previous research (Reba-Harrelson et al , 2008; Roerig et al , 2003), diet pill use was elevated in all ED groups. The ANBN group was at particularly elevated risk (i.e., approximately 15 times more likely than the referent).…”

“…The ANBN group was at particularly elevated risk (i.e., approximately 15 times more likely than the referent). Diet pill use has been associated with purging, novelty seeking, and several Axis I and Axis II disorders (Reba-Harrelson et al , 2008) which could explain why both the BN and ANBN groups, who tend to score higher on measures of novelty seeking (Cassin & von Ranson, 2005; Fernandez-Aranda et al , 2006; Reba et al , 2005), reported more use than the AN group.…”

“…Those who endorse binge eating, including those with bulimia nervosa (BN) and a lifetime history of both anorexia nervosa and bulimia nervosa (ANBN), tend to exhibit higher levels of licit and illicit drug use (Herzog et al , 1992; Hudson et al , 2007; Root et al , in press; Ross & Ivis, 1999; CASA, 2003; Wiederman & Pryor, 1996), including use of diet pills (Reba-Harrelson et al , 2008), than individuals with AN or no ED. For example, females with purging symptoms are more likely to report frequent alcohol use and binge drinking than females without ED symptoms (Adams & Araas, 2006).…”

Latent class analysis of eating and impulsive behavioral symptoms in Taiwanese women with bulimia nervosa

“…The characteristics of individuals with different compensatory behaviors, such as exercise, vomiting, laxative use, and diet pill use, have been studied in eating disorder (ED) patients [18][19][20][21][22]. Notably, laxative abuse is most frequently associated with greater general psychopathology, self-injurious behavior, suicide attempts, history of depression and anxiety, borderline personality features, and greater eating symptomatology [22].…”

Treating Eating Disorders Mindfully

“…28 Diet pill use was among the compulsive weight-control behaviors and types of substance abuse seen in 1345 women. 29 Treatment for alcohol dependence may lead to reduction of eating pathology. 30 Therefore, screening for all types of substance abuse is advised for patients with eating disorders.…”