Caught in the Bulimic Trap? Socioeconomic Status, State Dependence, and Unobserved Heterogeneity
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 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.
|Date of creation:||May 2009|
|Date of revision:|
|Contact details of provider:|| Postal: |
Phone: +34 93 542-1222
Fax: +34 93 542-1223
Web page: http://www.barcelonagse.eu
More information through EDIRC
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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.
- 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.
- 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 Goeree & John Ham & Daniela Iorio, 2011. "Caught in the Bulimic Trap? Persistence and State Dependence of Bulimia Among Young Women," Working Papers 2011-033, Human Capital and Economic Opportunity Working Group.
- 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).
- Richards, Timothy J. & Patterson, Paul M. & Tegene, Abebayehu, 2004. "Obesity and Nutrient Consumption: A Rational Addiction?," Working Papers 28539, Arizona State University, Morrison School of Agribusiness and Resource Management.
- 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.
- 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.
When requesting a correction, please mention this item's handle: RePEc:bge:wpaper:386. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Bruno Guallar)
If references are entirely missing, you can add them using this form.