A comparison of the binge eating scale, questionnaire for eating and weight patterns-revised, and eating disorder examination questionnaire with instructions with the eating disorder examination in the assessment of binge eating disorder and its symptoms

OBJECTIVE: The current study assesses concordance between self-administered measures and a diagnostic standard for assessment of binge frequency and diagnosis of binge eating disorder (BED) in a sample of binge eaters. METHOD: The Questionnaire for Eating and Weight Patterns-Revised (QEWP-R), Binge Eating Scale (BES), two items from the Eating Disorder Examination Questionnaire with Instructions (EDE-Q-I), and the Eating Disorder Examination (EDE) were administered. Participants were 157 adults volunteering for a clinical study, of whom 129 (79%) were diagnosed with BED using the EDE as the diagnostic standard. RESULTS: In the identification of BED, the QEWP-R yielded a sensitivity value of .74 and a specificity value of .35. The BES yielded a sensitivity value of .85 and a specificity value of .20. Frequency of binge eating days and episodes on the EDE-Q-I correlated highly with the EDE (.65 and .48, respectively; p < .001). DISCUSSION: The accuracy of diagnosis and symptomatology among self-administered questionnaires is variable. The BES and the QEWP-R performed satisfactorily as initial screens for the diagnosis of BED, but were less accurate in identifying non-BED individuals and the frequency of binge eating. The EDE-Q-I most accurately assessed the frequency of binge eating.     

Binge eating and binge eating disorder in a small-scale, indigenous society: the view from Fiji

OBJECTIVE: Although the cross-cultural prevalence of anorexia and bulimia nervosa has been investigated in multiple studies, little is known about the prevalence and correlates of binge eating and binge eating disorder (BED) cross-culturally. No published studies to date have explored BED in small-scale, indigenous, or developing societies. The current study investigated the prevalence and correlates of binge eating in a community sample of Fijian women living in rural Fiji. METHODS: Fifty ethnic Fijian women completed a self-report measure developed for this study on dieting and attitudes toward body shape and change, a Nadroga-language questionnaire on body image, and the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Their height and weight were also measured. Patterns of dieting, high body mass index (BMI), and attitudes toward eating and body image were compared between women with and without a history of binge eating. RESULTS: Ten percent of respondents reported at least weekly episodes of binge eating during the past 6 months and 4% endorsed symptoms consistent with BED. Binge eating in this sample was associated significantly with a BMI value above 35, a history of dieting, and a high concern with body shape. Binge eating was not associated with several markers of acculturation in this sample, although it was associated with a key, nontraditionally Fijian (i.e., acculturated) attitude toward the body. DISCUSSION: Binge eating occurred in a social context with traditions concerning weight and diet widely disparate from Western populations. However, correlates of binge eating in this sample suggest that nontraditional Fijian attitudes toward weight and body shape play a contributory role.     

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.     

Binge eating disorder and night eating syndrome: psychological and behavioral characteristics.

OBJECTIVE: The present study was designed to examine the psychological and behavioral characteristics associated with both night eating syndrome (NES) and binge eating disorder (BED) in 42 males and 41 females who were enrolled in a university-based weight loss center. METHOD: Individuals were classified into one of four groups: NES only (N = 23), BED only (N = 13), both NES and BED (N = 13), or no diagnoses of an eating disorder (N = 34). Analyses of covariance (covarying for age and gender) were conducted to compare patients with BED and NES. RESULTS: NES patients scored lower on disinhibition than BED patients (p <.01). Also, individuals who met criteria for both disorders scored higher than NES only patients on state anxiety (p <.01), disinhibition (p =.08), and trait anxiety (p =.08). DISCUSSION: These results suggest that NES represents a subcategory among the obese, which also overlaps with binge eaters. In addition, anxiety distinguished individuals who met criteria for both disorders from patients who were diagnosed with either NES or BED.     

Satiety and test meal intake among women with binge eating disorder

OBJECTIVE: The purpose of the study was to measure test meal consumption and the changes in hunger and fullness during a test meal in obese individuals with and without binge eating disorder (BED) and normal-weight controls. METHOD: Twelve women with BED, 12 obese control participants, and 12 normal-weight control participants participated in two single-item test meal sessions. In one session participants were instructed to "binge," and the other eat a normal meal. Participants made ratings of hunger and fullness on visual analog scales after every 75-g increment of food. RESULTS: In comparison to obese or normal-weight controls, patients with BED consumed significantly more food to reach a similar level of fullness or hunger. CONCLUSION: Individuals with BED consumed significantly more food and showed blunted changes in hunger and fullness during both the binge and nonbinge meals. These findings suggest that individuals with BED may have disturbances in satiety that in some ways resemble those described among individuals with bulimia nervosa.     

Correlates of subjective and objective binge eating in binge-purge syndromes

OBJECTIVE: Research has begun to challenge the idea that a large amount of food is a diagnostically relevant distinction in classifying binge eating. This study examined the relationship between both objective and subjective (i.e., feeling out of control while eating an appropriate amount of food) binge eating frequency and factor analytically derived measures of dieting and psychopathology. METHOD: Participants were 40 women who were admitted for inpatient treatment for bulimia nervosa, anorexia nervosa, binge-purge type, or eating disorder not otherwise specified with binge-purge symptoms. RESULTS: Controlling for subjective binge frequency, neither the psychopathology nor the dieting factors were related to objective binge frequency. Controlling for objective binge frequency, dieting, but not psychopathology, was related to subjective binge frequency. There was no correlation between frequency of subjective and objective binge eating. DISCUSSION: The results are discussed in light of research on restrained eating. Implications for diagnosis and the role of loss of control in defining binge behavior are also discussed.     

Importance of size in defining binge eating episodes in bulimia nervosa

OBJECTIVE: This study sought to determine if amount of food consumed is important in defining binge eating episodes in individuals with bulimia nervosa (BN). METHOD: Women (N = 30) with DSM-IV BN (OBN) and women (N = 25) who would have met DSM-IV criteria for BN except that their binge episodes were not objectively large (SBN) were recruited from the community. Subjects completed telephone interviews and questionnaires. RESULTS: Results demonstrated no significant differences between women with OBN and SBN in levels of dietary restraint, disinhibition, or hunger; no significant differences in general psychopathology; and significant differences in frequency of binge/purge episodes and impulsiveness. Differences in impulsiveness remained after controlling for frequency of binge/purge episodes. DISCUSSION: These results partially validate current diagnostic criteria for bulimia nervosa and elucidate one factor, impulsiveness, that may be important in understanding objective binge episodes in bulimia nervosa.     

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.     

Relations between dietary restraint, depressive symptoms, and binge eating: A longitudinal study

OBJECTIVE: Temporal relations between dietary restraint, depressive symptoms, and binge eating were tested by means of three competing models positing that (1) dietary restraint and depressive symptoms predict future increases in binge eating, (2) binge eating predicts future increases in dietary restraint and depressive symptoms, and (3) binge eating is reciprocally related to these two factors. METHOD: Longitudinal data from a community sample of Dutch females (N = 143; M age = 19.6) was used to test these relations while controlling for initial levels of these factors. RESULTS: Dietary restraint did not predict future increases in binge eating, nor did binge eating predict future increases in dietary restraint. Depressive symptoms predicted future increases in binge eating, but binge eating did not predict future increases in depressive symptoms. CONCLUSION: Although this study had limited statistical power, the pattern of relations and effect sizes suggest that depressive symptoms, but not dietary restraint, increase risk of binge eating for late adolescent females.     

Daily stress, coping, and dietary restraint in binge eating

OBJECTIVE: The current study evaluated whether psychological stress, use of specific coping strategies, and trait dietary restraint would prospectively predict binge eating episodes. METHOD: After completing a baseline measure of restraint, 46 binge eating college women kept daily diaries assessing depressed affect, stress, coping, and binge eating for 30 days. RESULTS: Regardless of level of depressed mood, higher stress was associated with increased risk of same-day binge eating; distraction coping was associated with increased risk of future binge eating; social support was associated with decreased risk of same-day binge eating; and women with high versus low dietary restraint showed different patterns of relationship for stress, coping, and binge eating. DISCUSSION: Vulnerability to binge eating in women who differ in terms of dietary restraint level may vary as a function of their coping responses to stress. Results highlight the complexities of stress and coping in binge eating.