This is a survey of the prevalence of weight reducing and weight gaining in high school children. Our sample of 1,373 high school girls and boys was geographically, racially, and economically diverse. On the day of the survey, 63% of the girls and 16.2% of the boys reported being on weight reducing regimens; 9.1% of the girls and 28.4% of the boys were trying to gain weight. Most female reducers and male gainers were already normal weight. Compared to other racial groups, whites and Hispanics were more likely to be reducing, whereas blacks were more likely to be gaining. Exercise and moderate caloric reduction were most popular for weight reducing, and a small but significant number were regularly using fasting, vomiting, laxatives, and appetite suppressants. The direction of weight modification for girls and boys conformed to stereotyped physical ideals. The rate of weight reducing in female high school adolescents has increased significantly since similar surveys of American youths 20 years ago.

\ controlled study evaluating the effectiveness of exposure plus response-prevention treatment of bulimia nervosa was conducted in a sample of 47 women. This wasa four-group comparison involving three treatment conditions and a waiting-list control group. The three treatment conditions were (a) exposure plus response prevention conducted in a single setting (clinic), (b) exposure plus response prevention conducted in multiple settings (clinic, patients' homes, and restaurants), and (c) cognitive-behavioral therapy without exposure plus response prevention. All treatment was provided to groups of 3 patients at a time. Outcome was evaluated at posttreatment and at a 6-month follow-up. The three treatment groups improved significantly on most outcome measures, whereas the waiting-list control group showed little change. At follow-up, there was a slightly better outcome on vomiting behavior and amount of food consumed in one of the test meals for the exposure plus response-prevention groups relative to the no-exposure group. However, on all other measures, the degree of improvement from prelreatment to follow-up was the same for all three treatment groups.Bulimia nervosa (Russell, 1979) refers to an eating disorder in which normal-weight individuals, almost always women, habitually vomit or abuse laxatives after binge-eating or after eating even minimal amounts of "forbidden" foods that they consider dangerously fattening. As with most complex behavior disorders, there is probably no single cause of bulimia nervosa.Most often cited in the literature are the cultural pressures on women to be slim; the desire to achieve some idealized image of the perfect body to compensate for low self-esteem and fears of rejection; negative mood states including depression; interpersonal stress with poorly developed problem-solving and assertion skills; poor eating and weight-control habits highlighted by the attempt to adhere to an unrealistically rigid and drastically restrained diet; and a host of distorted cognitions about nutrition, weight, and appearance.Without discounting the importance of all of these factors, we have noted previously (Leitenberg, Gross, Peterson, & Rosen, 1984;Rosen & Leitenberg, 1985) that these explanations neglect the special and central role that vomiting plays in this disorder as distinguished from other eating disorders. We have suggested that vomiting serves an anxiety-reducing function similar to compulsive hand-washing and checking rituals in obsessive-compulsive neuroses. For bulimia nervosa patients, eating most foods is in some ways parallel to bringing obsessivecompulsive patients into contact with substances they believe to be contaminating. A wide variety of foods of normal quantity are considered unsafe, repulsive, and fattening. Vomiting is the magic ritual that patients believe protects them from terrify-We wish to thank Sue Cado and Karen Fbndacaro for their assistance with data collection and Bruce Compas for his helpful comments on an earlier draft of this article.

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Increasing attention has been given to measuring symptoms of eating disorders in adolescents, but representative norms for the two widely used measures, the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI), have not been available. The present study collected normative data on 1,373 high school boys and girls in Grades 9-12. Significant sex, but not age, differences were obtained. Scores by boys did not differ by race or socioeconomic status, (SES), whereas a few slight race and SES differences occurred among girls. Percentile ranks for raw scores are presented.

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