Relation of binge eating age of onset to functional aspects of binge eating in binge eating disorder

OBJECTIVE: This study examined whether age of binge eating onset in binge eating disorder (BED) is related to affective binge eating antecedents and consequences. METHOD: Participants included women (N = 44) with BED who participated in a group cognitive-behavioral therapy (CBT) study. Measures included the Eating Hedonics Questionnaire, Beck Depression Inventory, Multidimensional Personality Questionnaire Negative Emotionality factor, Restraint Scale, Three-Factor Eating Questionnaire Restraint factor, and Eating Behaviors-IV. Participants were classified according to reported age of binge eating onset, with early onset defined as 13 years (LOB; n = 19). RESULTS: Compared with LOB, EOB was associated with reductions in postbinge subjective anxiety, but not depression. DISCUSSION: This study suggested that EOB in BED may be associated with binge eating as an affective means of coping, particularly with anxiety, and further supported age of binge eating onset as a clinically meaningful way to delineate BED subclassifications.     

Subthreshold binge eating disorder

OBJECTIVE: To examine the clinical features of subthreshold binge eating disorder (BED). METHOD: Participants were recruited directly from the community as part of an ongoing study of risk factors for BED. Forty-four women with subthreshold BED were compared with 44 women with BED and 44 healthy controls on demographic characteristics, body mass index (BMI), eating disorder symptomatology, and psychiatric distress. Diagnoses were established using the Eating Disorder Examination (EDE). Participants completed the EDE-Questionnaire, the Brief Symptom Inventory, and were measured and weighed. RESULTS: Adjusting for significant group differences in BMI, the two eating disorder groups did not differ significantly on measures of weight and shape concern, restraint, psychiatric distress, and history of seeking treatment for an eating or weight problem. DISCUSSION: Given the importance of diagnostic status for access to treatment, further evaluation of the severity criterion specified for BED is needed.     

Hedonics of binge eating in women with bulimia nervosa and binge eating disorder.

OBJECTIVE: Potential differences in the hedonics of binge eating between female subjects with bulimia nervosa (BN) and female subjects with binge eating disorder (BED) were examined. METHOD: Women seeking treatment for BN (N = 29) and BED (N = 49) completed the Eating Hedonics Questionnaire. RESULTS: Subjects in both groups reported similar precipitants and levels of distress associated with binge eating. Of interest, BED subjects were more likely to report that they enjoyed the food, the taste of the food, the smell and the texture of the food while binge eating. In addition, the BED group reported more relaxation and less physical discomfort and anxiety as a consequence of binge eating compared to the BN group. DISCUSSION: There are interesting and potentially important differences between individuals with BN and BED in the cognitions and behaviors associated with binge eating.     

Nocturnal eating in binge eating disorder and matched-weight controls

Objective: To examine the association of nocturnal eating (getting up out of bed to eat) with overweight, binge eating, and negative mood or anxiety. Method: Forty overweight women diagnosed with binge eating disorder (BED) and 39 overweight controls monitored their nocturnal eating for an average of eight nights. Results: Seven instances of nocturnal eating were recorded by 6 patients, all of whom were binge eaters. Foods consumed nocturnally tended to be selected from those favored for binge episodes, and reported control over nocturnal eating was low. Patients reported tiredness, but not poor mood or anxiety, at the nocturnal eating episodes. Discussion: In this sample, nocturnal eating was associated more with eating disorder than overweight. This report should provide the basis of future work to determine whether nocturnal eating should be evaluated and treated among eating disordered or overweight groups of patients. © 1995 by John Wiley & Sons, Inc.     

Night eating and binge eating disorder in obese patients

OBJECTIVE: To investigate the relationships between binge eating disorder and night eating in severely obese patients. DESIGN: Longitudinal study following biliopancreatic diversion, when any preoccupation with food and weight is completely abandoned. MATERIALS AND METHODS: Structured interview prior to the operation and at the 1, 2, and 3-year follow-up visit. RESULTS: Nearly complete disappearance of binging behavior and no changes in the frequency of night eating. CONCLUSION: Binge eating and night eating are widely overlapping but different behaviors; night eating appears to be fully independent of preoccupation with food and dieting.     

Stress response and binge eating disorder

In clinical practice, obese patients report stress as a primary trigger for binge eating. However, the biological mechanism underlying this relationship is poorly understood. This paper presents, a theoretical overview of how cortisol secretion, a major component of the stress response, could play a role in binge eating, given that exogenous glucocorticoids can lead to obesity by increasing food intake. I will discuss findings from recent studies demonstrating links between laboratory stress, cortisol, food intake and abdominal fat in humans. Cortisol is elevated following laboratory stressors in women with anorexia nervosa (AN), bulimia nervosa (BN), and obesity, but has not been widely studied in women with binge eating disorder (BED). Additionally, I will review recent findings demonstrating a greater cortisol response to stress in obese women with BED compared to non-BED.     

Placebo response in binge eating disorder

OBJECTIVE: Placebo response in studies of binge eating disorder (BED) has raised concern about its diagnostic stability. The aims of this study were (1) to compare placebo responders (PRs) with nonresponders (NRs); (2) to investigate the course of BED following placebo response; and (3) to examine attributions regarding placebo response. METHOD: The baseline placebo run-in phase (BL) was part of a RCT investigating sibutramine hydrochloride for BED; it included 451 participants, ages 19-63, diagnosed with BED. Follow-up (FU) included 33 PRs. RESULTS:: In this study, 32.6% of participants responded to placebo (PRs = 147; NRs = 304). PRs exhibited significantly less symptom severity. At FU (n = 33), many PRs reported continued symptoms. CONCLUSION: PRs exhibited significantly less severe pathology than NRs. Placebo response in BED may transitory or incomplete. The results of this study suggest variable stability in the BED diagnosis.     

Eating behavior in binge eating disorder

In order to examine the eating behavior of individuals with the newly proposed diagnosis, binge eating disorder (BED), standardized meals were served to 20 obese women, 10 with BED and 10 without BED. When asked to binge eat from a multiple-item array of foods, obese subjects with BED consumed significantly more calories than did obese subjects without BED. Significant differences between the two groups were also found on several of the self-report measures. © 1993 by John Wiley & Sons, Inc.     

Eating Disorder Examination-Questionnaire with and without instruction to assess binge eating in patients with binge eating disorder

OBJECTIVE: The current study examined whether adding written definitions and examples of binge eating to the Eating Disorder Examination-Questionnaire enhances its utility to assess binge frequency in patients with binge eating disorder (BED). METHOD: Eighty-nine women and men with BED completed the EDE-Q (without instruction; n = 37) or the EDE-Q-I (with instruction; n = 52) before receiving the EDE interview. Binge frequency was measured as the number of binge days (days on which one or more objective binge episodes occurred) over the past 28 days. RESULTS: Binge frequency correlations between the EDE and EDE-Q-I were strongly significant (r = .543, p = .000), whereas correlations between the EDE and EDE-Q were not significant (r = .197, p = .242). DISCUSSION: Providing brief detailed instructions improves the performance of the EDE-Q when evaluating binge eating in patients with BED. This suggests that, with relatively minor modifications, the EDE-Q may be a viable alternative to the EDE in assessing binge frequency in this population.     

Characteristics of binge eating among women in the community seeking treatment for binge eating or weight loss

This study examined characteristics of binge eating among overweight women in the community seeking treatment for binge eating or weight loss. Five hundred and ninety-two women completed a telephone interview in which binge eating was thoroughly assessed. A large percentage of the sample (84.4%) reported features of binge eating consistent with the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) definition of a binge. A significantly higher rate of DSM-IV BED (33.6%) was found compared to previous studies. Eleven percent of the sample denied bingeing/purging (nonbinge eating disorder, NBED) and 55.4% of the sample reported other eating problems such as bingeing or purging. Women with binge eating disorder (BED) had a higher BMI, became overweight earlier, and reported more unhealthy weight control methods than NBED women. BED women also reported more current and past depression and suicidal ideation than NBED women. BED reported more maternal overweight than NBED, but BED and NBED participants did not differ in paternal overweight or parental eating disorders. Future studies should investigate the relationship between binge eating and suicidal ideation to better understand whether depression precedes or follows binge eating.     

Evaluating binge eating disorder in children: development of the children's binge eating disorder scale (C-BEDS)

OBJECTIVE: Binge eating disorder (BED) may manifest itself differently in children than adults. Recently researchers have proposed provisional criteria for measuring BED in children. The purpose of this study was to develop a brief, simple, structured, interviewer-administered scale (C-BEDS) to measure BED in children according to the provisional criteria and to compare diagnostic results with SCID diagnoses. METHOD: A total of 55 children between the ages of 5 and 13 were interviewed with both the SCID and the C-BEDS. RESULTS: There was a significant association between the two measures (p = .001). Both measures adequately identified children with binge eating behaviors. CONCLUSION: Both the provisional criteria and the C-BEDS may be developmentally appropriate for use with children, although the C-BEDS may be a better screening instrument as it quickly identified children with subsyndromal BED. If used by physicians and other health providers, this brief measure may assist with identifying early onset binge eating behaviors and avoiding the associated consequences, including adult BED, obesity, and other comorbidities.     

Maintenance of binge eating through negative mood: a naturalistic comparison of binge eating disorder and bulimia nervosa

OBJECTIVE: To examine negative mood as a proximal antecedent and reinforcing condition of binge eating in binge eating disorder (BED) and bulimia nervosa (BN). METHOD: Using an ecological momentary assessment design, 20 women with BED, 20 women with BN, and 20 nonclinical control women were recruited from the community, provided with a portable minicomputer, and asked to rate their mood and list their thoughts at randomly-generated beep sounds and before, during, and after episodes of eating. RESULTS: In both eating disorder groups mood before binge eating was more negative than before regular eating and at random assessment. Binge eating was followed by a deterioration of mood. The BED group revealed less antecedent negative mood than the BN group and less concomitant negative cognitions about food/eating and stress. CONCLUSION: Affect regulation difficulties likely lead to binge eating in both disorders, but binge eating may not be effective for regulating overall mood.