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Caught in the Bulimic Trap? Persistence and State Dependence of Bulimia Among Young Women

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  • Michelle Goeree

    ()
    (University of Zurich)

  • John Ham

    (University of Maryland, Institute on Poverty, and IZA)

  • Daniela Iorio

    (Universitat Autonoma de Barcelona)

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    Abstract

    Eating 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. 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 findings have important implications for public policy since they 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 specifications and identifying assumptions.

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    File URL: http://humcap.uchicago.edu/RePEc/hka/wpaper/Goeree_Ham_Iorio_2011_caught-bulimic-trap.pdf
    File Function: First version, February 10, 2011
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    Bibliographic Info

    Paper provided by Human Capital and Economic Opportunity Working Group in its series Working Papers with number 2011-033.

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    Date of creation: Feb 2011
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    Handle: RePEc:hka:wpaper:2011-033

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    Keywords: Bulimia Nervosa; Demographics; State Dependence; Instrumental Variables; Dynamic Panel Data Estimation; and Addiction;

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    References

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    1. Donna B. Gilleskie & Koleman S. Strumpf, 2005. "The Behavioral Dynamics of Youth Smoking," Journal of Human Resources, University of Wisconsin Press, vol. 40(4), pages 822-866.
    2. 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.
    3. 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).
    4. Ivora Hinton & Jessica Howell & Elizabeth Merwin & Steven N. Stern & Sarah Turner & Ishan Williams & Melvin Wilson, 2010. "The Educational Pipeline for Health Care Professionals: Understanding the Source of Racial Differences," Journal of Human Resources, University of Wisconsin Press, vol. 45(1).
    5. Adams, Peter & Hurd, Michael D. & McFadden, Daniel & Merrill, Angela & Ribeiro, Tiago, 2003. "Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status," Journal of Econometrics, Elsevier, vol. 112(1), pages 3-56, January.
    6. Anirban Basu & James J. Heckman & Salvador Navarro-Lozano & Sergio Urzua, 2007. "Use of instrumental variables in the presence of heterogeneity and self-selection: an application to treatments of breast cancer patients," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1133-1157.
    7. Inas Rashad, 2006. "Structural Estimation of Caloric Intake, Exercise, Smoking, and Obesity," NBER Working Papers 11957, National Bureau of Economic Research, Inc.
    8. Maxim Engers & Steven Stern, 2002. "Long-Term Care and Family Bargaining," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 43(1), pages 73-114, February.
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    Cited by:
    1. Michelle S. Goeree & John C. Ham & Daniela Iorio, 2011. "Race, Social Class, and Bulimia Nervosa," Working Papers 2011-034, Human Capital and Economic Opportunity Working Group.
    2. Goeree, Michelle S. & Ham, John C. & Iorio, Daniela, 2011. "Race, Social Class, and Bulimia Nervosa," IZA Discussion Papers 5823, Institute for the Study of Labor (IZA).

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