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To determine the frequency and intensity of bulimic symptoms related to psychosocial impairment and health care utilization.Females (N = 1231, M age = 17.7, range 13–55) from four communityrecruited samples varying in bulimic pathology completed the eating disorder examination, social adjustment scale, and health survey utilization scale.Co-occurrence of binge eating and compensatory behaviors and solely compensatory behaviors ≥1 time/month were associated with elevations in psychosocial impairment. Co-occurrence of both binge eating and compensatory behaviors and solely compensatory behaviors ≥8 times/month were related to greater service utilization. Solely binge eating and duration of bulimic behaviors were unrelated to these functional outcomes. Overvaluation of body shape and weight showed significant linear relations to the functional outcomes.Results suggest that current diagnostic thresholds for bulimia nervosa may be too high when considering functional impairment and service utilization and that different cut-points need to be considered for different bulimic symptoms. © 2007 by Wiley Periodicals, Inc.