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Young' Adult Women and tutting' Disorder Not Otherwise Specified

Adolescent boys and adult men certainly experience EDs (Ousley, Cordero, & White, 2008; Stout & Frame, 2004). In fact, Neumark-Sztainer (2005) reported that as many as 30% of the adolescent boys they studied expressed body dissatisfaction and were engaging in unhealthy weight management behaviors. However, boys and men with eating-related concerns are far outnumbered by girls and women (Hoek, 2006; Wittichen & Jacobi, 2005). Internationally, EDs are among the 10 most common causes of psychological distress among young adult women (Mathers, Vos, Stevenson, & Begg, 2000).

Previous authors have agreed that essentially all girls and women in the United States are pressured by factors associated with disordered eating (Peck & Lightsey, 2008; Striegel-Moore & Bulik, 2007), and counselors working in various settings are likely to find female clients with eating concerns in their caseloads (Choate & Schwitzer, 2009; Lewinsohn, Seeley, Moerk, & Striegel-Moore, 2000). For example, adolescent girls and young adult women in their 20s experience the highest risk for developing these types of problems (Stice, 2002; Striegel-Moore & Bulik, 2007). As follows, on college campuses, with large concentrations of young adult female students, the high incidence of EDs has been especially well documented (Gallagher, Golin, & Kelleher, 1992; Koszewski, Newell, & Higgins, 1990; G. A. Miller & Rice, 1993). Moreover, in the United States, although EDs were historically associated primarily with European American girls and women, these concerns are now seen with regularity among various ethnic

populations (Becker, Franko, Speck, & Herzog, 2003; Cachelin & Striegel- Moore, 2006; Talleyrand, 2010; Tsai, Hoerr, & Song, 1998). Along these lines, Rich and Thomas (2008) found very few differences in disordered eating symptoms among African American, Latina, and White college women (Rich & Thomas, 2008; see also Chapter 3, this volume).

More important, although the major EDs – anorexia and bulimia – certainly occur among girls and women with some frequency, especially in clinical settings, the eating-related problems most likely to be seen by practitioners are, by far, the heterogeneous group of less severe problems diagnosed as EDNOS. For example, on college campuses, only 6% of female students reported concerns about anorexia or bulimia, whereas 25% to 40% reported moderate problems potentially falling into the EDNOS category – including body image worries, problems with weight management, out-of-control eating, and misperceiving normal versus disordered body size and eating and weight management behaviors (Bishop, Bauer, & Baker, 1998; Schwitzer, Rodriguez, Thomas, & Salimi, 2001; Tsai et al., 1998; Yost & Smith, 2012). Likewise, looking beyond collegiate populations, recent researchers have generally agreed that the large majority of young adult women with eating-related difficulties have disorders that fit into the EDNOS category (Fairburn & Bohn, 2005; Schwitzer et al., 2008; Shisslak, Crago, & Estes, 1995; Wilson, Grilo, & Vitousek, 2007; Wonderlich, Joiner, Keel, Williamson, & Crosby, 2007).

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