Diagnosis of binge eating disorder: Discrepancies between a questionnaire and clinical interview

Binge eating is a common problem among obese individuals, and a simple, accurate way to identify obese binge eaters is needed. This study measured the concordance of the Binge Eating Scale (BES) and the Eating Disorder Examination (EDE). Women seeking obesity treatment (N = 126) were identified as binge eaters or nonbinge eaters using the BES, and then interviewed by clinicians blind to BES score using the EDE, a semistructured interview considered to be the “gold standard” for eating disorder diagnosis. The BES accurately identified nonbinge eaters; 39 of 42 (92.9%) BES-identified nonbinge eaters were confirmed by the EDE. However, the BES did not accurately identify binge eaters; only 43 of the 83 (51.8%) BES-identified binge eaters were confirmed by the EDE. Reasons for the discrepancy between the BES and the EDE in the identification of binge eaters were explored, and modifications to the BES that might improve its accuracy were considered. © 1995 by John Wiley & Sons, Inc.     

Binge eating disorder: A multisite field trial of the diagnostic criteria

Diagnostic criteria have been developed for a new eating disorder, binge eating disorder (BED), to describe the many individuals who have problems with recurrent binge eating but do not engage in the characteristic compensatory behaviors of bulimia nervosa, vomiting, or use of laxatives. The results of a multisite field trial involving 1,984 subjects indicate that the disorder is common (30.1%) among subjects attending hospital-affiliated weight control programs, but is relatively rare in the community (2.0%). The disorder is more common in females than in males and is associated with severity of obesity and a history of marked weight fluctuations. Based on these results, the DSM-IV Work Group on Eating Disorders has recommended that the disorder be considered for inclusion in DSM-IV, either as an official category or in an appendix of categories requiring further study.     

A careful biomedicine? Generalization and abstraction in RCTs

This article takes up biomedical and public health concerns about the difficulty of generalizing or extrapolating measurements of efficacy produced by the method of the randomized control trial (RCT) to wider populations. While explanations for the difficulty may be deduced from social studies of science that reveal the contingent and situated nature of trial findings, new conceptual tools are required to allow for the practical value associated with the possibility of their extrapolation. We argue that Alfred North Whitehead’s concept of ‘abstraction’ can provide an alternative appreciation of some key aspects of the processes of knowledge-production of RCTs to enable a recasting of the problem of generalization. By proposing that generalization depends on relevant abstractions, we direct attention to the situated forms of care that this calls for. After showing the conceptual difference that the process of abstraction makes for understanding and extrapolating the situated nature of a research finding, we offer an interpretation of possible forms of care at work in efforts to devise Ebola adaptive trials. The example is offered as one possible basis for a reformulation of the logic of generalization.