Caught in the Bulimic Trap? Socioeconomic Status, State Dependence, and Unobserved Heterogeneity
AbstractEating disorders are an important and growing health concern, and bulimia nervosa (BN) accounts for the largest fraction of eating disorders. Health consequences of BN are substantial and especially serious given the increasingly compulsive nature of the disorder. However, remarkably little is known about the mechanisms underlying the persistent nature of BN and the socioeconomic groups that are most likely to be at risk. Using a unique panel data set on young women and instrumental variable techniques, we document that unobserved heterogeneity plays a role in the persistence of BN, but strikingly up to two thirds is due to true state dependence. Our results, together with support from the medical literature, provide strong evidence that bulimia should be considered an addiction. We also find that African Americans are more likely to exhibit and persist in bulimic behavior than Whites; as are girls from low income families compared to middle and high income families. These results stand in stark contrast to the popular conceptions of who is most likely to experience BN, and we argue that this is due to differences in the diagnosis across racial and income classes. Our findings have important implications for public policy since they i) provide direction to policy makers regarding which adolescent females are most at risk for BN, and ii) suggest that the timing of the policy is crucial: preventive educational programs should be coupled with more intense (rehabilitation) treatment at the early stages of bingeing and purging behaviors. Our results are robust to different model specications and identifying assumptions.
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Bibliographic InfoPaper provided by Barcelona Graduate School of Economics in its series Working Papers with number 386.
Date of creation: May 2009
Date of revision:
Bulimia Nervosa; Demographics; State Dependence; Instrumental Variables; and Dynamic Panel Data Estimation; Addiction;
Find related papers by JEL classification:
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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- Rashad, Inas, 2006.
"Structural estimation of caloric intake, exercise, smoking, and obesity,"
The Quarterly Review of Economics and Finance,
Elsevier, vol. 46(2), pages 268-283, May.
- Inas Rashad, 2006. "Structural Estimation of Caloric Intake, Exercise, Smoking, and Obesity," NBER Working Papers 11957, National Bureau of Economic Research, Inc.
- John Ham & Daniela Iorio & Michelle Sovinsky, 2012.
"Caught in the Bulimic Trap? Persistence and State Dependence of Bulimia Among Young Women,"
2012-018, Human Capital and Economic Opportunity Working Group.
- Goeree, Michelle S. & Ham, John C. & Iorio, Daniela, 2011. "Caught in the Bulimic Trap? Persistence and State Dependence of Bulimia Among Young Women," IZA Discussion Papers 5824, Institute for the Study of Labor (IZA).
- Michelle S. Goeree & John C. Ham & Daniela Iorio, 2009. "Caught in the bulimic trap? Persistence and state dependence of bulimia among young women," IEW - Working Papers 447, Institute for Empirical Research in Economics - University of Zurich, revised Jul 2012.
- Richards, Timothy J. & Patterson, Paul M. & Tegene, Abebayehu, 2004.
"Obesity and Nutrient Consumption: A Rational Addiction?,"
28539, Arizona State University, Morrison School of Agribusiness and Resource Management.
- Timothy J. Richards & Paul M. Patterson & Abebayehu Tegene, 2007. "Obesity And Nutrient Consumption: A Rational Addiction?," Contemporary Economic Policy, Western Economic Association International, vol. 25(3), pages 309-324, 07.
- Richards, Timothy J. & Patterson, Paul M. & Tegene, Abebayehu, 2004. "Obesity And Nutrient Consumption: A Rational Addiction?," 2004 Annual meeting, August 1-4, Denver, CO 20079, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
- Andrew M. Jones & José M. Labeaga, 2003. "Individual heterogeneity and censoring in panel data estimates of tobacco expenditure," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(2), pages 157-177.
- Donna B. Gilleskie & Koleman S. Strumpf, 2000.
"The Behavioral Dynamics of Youth Smoking,"
NBER Working Papers
7838, National Bureau of Economic Research, Inc.
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