Dramatic differences exist between women and men in the prevalence of disordered eating. In 1 study, the prevalence of moderate obesity, defined as a weight 30% to 50% higher than normal, was 11% for women versus 8% for men, a small but significant difference.[1] Severe obesity (>50% above the recommended weight) affects 4 times as many women (8%) as men (2%).. Furthermore, altered eating may be a part of the symptomatology of other disorders occurring in women, such as premenstrual syndrome. Thus, major clinical challenges confront women who are affected by an eating disorder and their physicians.

Why do these disorders occur more commonly in women? Although there has been rapid progress in the last decade in the analysis of the physiologic controls of eating in animals, the potential contribution of physiologic factors to the etiology and courses of these disorders remains obscure. However, a wealth of data indicates that the hypothalamic-pituitary-ovarian axis has significant effects on eating in animals and that estradiol is a key link in controlling eating in normally cycling adult females. These findings have potential heuristic and mechanistic significance for normal and disordered eating in women, suggesting that manipulation of estradiol's effects on eating may provide an opportunity for the development of pharmacologic treatment.