OBJECTIVE: To examine functional impairment associated with bulimic behaviors in a community sample of men and women.

METHOD: Binge eating, purging, fasting, extreme weight and shape concerns, and "days-out-of-role" were assessed in a community sample of men (n = 1,290) and women (n = 1,757) aged 15-94 years.

RESULTS: Participants who reported regular eating disorder behaviors had higher levels of functional impairment than those who did not. This was the case for both men and women and for each of the behaviors assessed, although differences between purgers and nonpurgers were not statistically significant. Also in both men and women, participants who reported eating disorder behaviors and weight or shape concerns had higher levels of impairment than those who reported these behaviors in the absence of weight or shape concerns. In multivariate analysis, binge eating, fasting and weight or shape concerns all contributed to the likelihood of impairment in men, whereas only the presence of weight or shape concerns was significantly associated with impairment in women.

CONCLUSION: Whereas bulimic behaviors are associated with elevated levels of functional impairment in both men and women, weight or shape concerns may be more central to the experience of this impairment in women.