Background: To date, the number of epidemiological studies on eating disorders (ED) in Italy and in other Mediterranean countries is still limited. This study evaluated the eating attitudes and the prevalence of eating disorders in a sample of 359 16-year-old Italian schoolgirls. Methods: The study followed a two-stage procedure consisting in a first screening stage followed by clinical interviews. A third stage consisting in a case register study and a 1-year follow-up confirmed the importance of evaluating subjects who chose not to participate in the survey. Results: Prevalence rates found in our sample are consistent with those of other prevalence studies conducted on adolescent girls: 0% for anorexia nervosa, 0.5% for bulimia nervosa and 3.7% for ED not otherwise specified. Also some important features associated with the presence of an ED appeared to be present in Italian female students, as in Anglo-Saxon populations: the tendency towards denial that led to an overrepresentation of ED among nonrespondents, and the ascertainment that just a small proportion of people seeks help for ED. The Italian sample reported higher scores on eating attitudes test compared to Anglo-Saxon samples. Conclusions: No evidence of different rates of ED was found in our Italian sample in comparison with non-Mediterranean samples. The importance of using a two-stage design and a third control stage in prevalence studies is emphasized by our findings.

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