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Health services use in eating disorders

Published online by Cambridge University Press:  02 November 2007

R. H. Striegel-Moore*
Department of Psychology, Wesleyan University, Middletown, CT, USA
L. DeBar
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
G. T. Wilson
Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
J. Dickerson
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
F. Rosselli
Department of Psychology, Manchester Community College, Manchester, CT, USA
N. Perrin
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
F. Lynch
Center for Health Research, Kaiser Permanente NorthWest, Portland, OR, USA
H. C. Kraemer
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
*Address for correspondence: R. H. Striegel-Moore, Ph.D., Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459-0408, USA. (Email:



This study examined healthcare services used by adults diagnosed with an eating disorder (ED) in a large health maintenance organization in the Pacific Northwest.


Electronic medical records were used to collect information on all out-patient and in-patient visits and medication dispenses, from 2002 to 2004, for adults aged 18–55 years who received an ED diagnosis during 2003. Healthcare services received the year prior to, and following, the receipt of an ED diagnosis were examined. Cases were matched to five comparison health plan members who had a health plan visit close to the date of the matched case's ED diagnosis.


Incidence of EDs (0.32% of the 104 130 females, and 0.02% of the 93 628 males) was consistent with prior research employing treatment-based databases, though less than community-based samples. Most cases (50%) were first identified during a primary-care visit and psychiatric co-morbidity was high. Health services use was significantly elevated in all service sectors among those with an ED when compared with matched controls both in the year preceding and that following the receipt of the incident ED diagnosis. Contrary to expectations, healthcare utilization was found to be similarly high across the spectrum of EDs (anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified).


The elevation in health service use among women both before and after diagnosis suggests that EDs merit identification and treatment efforts commensurate with other mental health disorders (e.g. depression) which have similar healthcare impact.

Original Articles
Copyright © 2007 Cambridge University Press

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